Her rheumatologist instructed her to undergo a baseline ocular examination prior to initiating Plaquenil (hydroxychloroquine, Sanofi-Aventis) therapy. Toxic maculopathy associated with chloroquine use was first documented in the literature five decades ago.1 In the United States, Plaquenil––an analog to chloroquine––is used to treat a variety of conditions, including rheumatoid arthritis, lupus and several distinct inflammatory disorders. Although the incidence of macular toxicity is infrequent with Plaquenil use (at a dosage of 200mg or 400mg q.d.), its visual impact can be devastating. Plaquenil and eyes side effects Plaquenil for rheumatoid arthritis pain Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease. Apr 20, 2011 The goal of monitoring/screening is to identify early macular damage prior to irreversible vision loss or even before visible signs of bull’s eye maculopathy. And although the current guidelines do not discuss the importance of continuous ocular care with an annual comprehensive eye exam, we believe that it is an essential consideration. 1. Plaquenil is the one drug that you need the eye exam prior to starting the drug as they really need that baseline. If it's going to affect your eyes, tends to do so in the first 6 months. but I don't think MTX is the same.doc hasn't made me get it prior to treatment but he is adamant about yearly eye exams. Initially, central visual acuity may be unaffected, but the patient may notice related paracentral scotomas that often interfere with reading. The associated classic retinal toxicity is described as a bull’s eye maculopathy (ring of depigmented retinal pigment epithelium that spares the foveal area). Do you need a baseline eye exam before taking hydroxychloroquine The Risk of Retinal Toxicity with Plaquenil, New Plaquenil Guidelines How is chloroquine madeDoes plaquenil cause mouth soresHydroxychloroquine test for eyes If you are taking hydroxychloroquine for a long period of time, your doctor will recommend frequent eye exams. It is very important that you keep these appointments. Hydroxychloroquine can cause serious vision problems. If you experience any changes in vision, stop taking hydroxychloroquine and call your doctor immediately. Do not let anyone else take your medication. Ask your pharmacist any questions you have about refilling your prescription. Hydroxychloroquine MedlinePlus Drug Information. Bone Joint Muscle - Arthritis Baseline eye exam and Methotrexate. PATIENT FACT SHEET Hydroxychloroquine Plaquenil. Otherwise, you should have a check up with an optician once a year and tell them that you're taking hydroxychloroquine. You should report any new eye symptoms to your doctor straight away. If you develop any other new symptoms or there's anything else that concerns you after starting hydroxychloroquine, you should tell your doctor or rheumatology nurse specialist as soon as possible. Plaquenil-induced toxicity usually will not occur before five years of taking the drug. “Eye damage due to Plaquenil is not common,” he says. “Rarely will anybody who has good vision and minimal symptoms develop loss of central vision or ability to read if annual screening is done and visual are symptoms reported as soon as they occur so the medication can be stopped if toxicity occurs. Minimum treatment guidelines recommend that every patient taking Hydroxychloroquine Plaquenil should have an annual eye exam after being on the medication for 5-years. But because your vision is priceless, Stonewire recommends annual eye health exams to all our patients on these medications and potentially we may escalate the frequency to every 6-months after 5-years.