Plaquenil (hydroxychloroquine) is a medication that is used for rheumatologic conditions. It is most commonly used to treat rheumatoid arthritis and lupus.
Plaquenil is a relatively safe drug, however it can rarely cause damage to the retina. The retina is the light-sensitive tissue that lines the inside of the eye. Damage to the retina can cause vision loss. If vision loss does occur, it happens very slowly, so slowly that the patient may not notice it. Today, we have many tests that are able to be performed in the office to identify early signs of toxicity, long before a patient will notice any vision changes. Since vision loss with Plaquenil can be permanent, it is very important to identify very early signs of toxicity so the Plaquenil can be discontinued before the patient is aware of any visual problems.
Patients should see an ophthalmologist as soon as they consider starting Plaquenil, and continue to see them every 6-12 months. During their visit, they should expect a dilated eye exam, as well as several tests. These tests include:
- Humphrey visual field: this tests your peripheral vision
- Optical coherence tomography (OCT): this takes a detailed image of the specific layers of the retina where damage can be first noticed.
- Patients should continue to see their rheumatologist and primary care physician while on Plaquenil.