Plaquenil is a proven and widely used medication in the treatment of rheumatoid arthritis, lupus, and other inflammatory conditions and autoimmune diseases. Around 400,000 prescriptions are written per month for Plaquenil in the United States (which dramatically increased when it was thought it helped decrease symptoms of COVID 19).
Although rare, taking Plaquenil can cause retinal toxicity that could lead to irreversible vision loss.
Patients starting treatment with Plaquenil should have a baseline eye examination within the first year of taking this medication and then regular exams either every 6 months or yearly, in a schedule agreed upon by the prescribing physician and eye care professional. This exam includes refraction, visual acuity, dilated fundus exam, visual field test and OCT.
In early toxicity from Plaquenil, there are no visible signs to the patient but there are changes that can be detected by the visual field and OCT testing. Generally, if there is Plaquenil toxicity present, it is in both eyes and symmetric. Risk factors that may increase the likelihood of Plaquenil toxicity include age over 60, daily dose of more than 400 mg, use of Plaquenil for more than 5 years, obesity, pre-existing retinal disease, and renal or liver failure. When the maximum daily dosage recommendations for Plaquenil are followed, the likelihood of toxicity is low.
As a patient taking Plaquenil, make sure to discuss the risks and benefits of this medication with both the prescribing physician and your eye doctor. You should also understand the benefits and limitations of visual screenings. Regular physical exams along with periodic comprehensive eye exams and testing are essential to monitor the health of your eyes while taking Plaquenil.
At Bechthold Jensen Eye Care we have all the equipment needed to monitor your eye health if taking Plaquenil and communicate all findings to the prescribing doctor. Please call if you have any questions, or to set up an eye exam today.