Hydroxychloroquine (Plaquenil) is an anti-rheumatic drug doctors prescribe to reduce inflammation and alleviate pain symptoms associated with rheumatoid arthritis and certain autoimmune disorders such as lupus and other connective tissue disorders. Although side effects of the drug that affect the eyes generally are rare, damage to the retina can occur if you take high doses of the medication or continue the medication for 5 years or more.
Because of the potential side effects, it's important to discuss with your doctor the risks and then weigh them against the benefits of taking the drug. Your doctor will also point out the importance of regular vision screenings with the use of hydroxychloroquine.
Before your rheumatologist begins treating your medical condition with hydroxychloroquine, he or she may recommend that you see your eye doctor for a comprehensive eye examination. Your eye care professional will perform vision tests to measure your visual acuity at the time you begin treatment with the drug. He or she also may test your peripheral (side) and color vision and check for changes to the structure of the retina that may already be present.
Taking preventive measures that lead to early detection of retinal damage can help stop the progression of any retinal disease that occurs.
Report any changes in your vision to your ophthalmologist or rheumatologist. You need to have symptoms such as blurry or decreased vision evaluated immediately. A decreased ability to notice red-green contrast can be a sign of early retinal toxicity – a condition that can affect visual acuity, night vision, and peripheral vision. Your eye doctor may perform color vision testing as part of a baseline eye examination and during your regular yearly eye exams.
While not everyone experiences symptoms of retinal toxicity early on, additional symptoms may occur, often in both eyes. Symptoms that some people report include difficulty reading, loss of central vision, flashing lights, glare, halos, light sensitivity, or distorted vision.
Get regular eye exams. Because the risk of retinal damage increases when you take a total cumulative dose of 1000 g of hydroxychloroquine, you should have vision testing at least annually. Other factors that can increase your risk of retinal toxicity include age (being older than 60), coexisting kidney or liver disease, and pre-existing retinal disease or maculopathy – damage to the middle part of the retina that affects central vision. Obesity can be a risk factor as well since recommended doses are based on normal body weight. Because the drug doesn't easily penetrate lipid-rich tissues, a doctor may prescribe higher daily doses, which increases the risk for toxicity.
The damage hydroxychloroquine can cause to your eyes is permanent and may continue to progress; therefore, it's important for your doctor to detect any problems with your eyes early on. If your vision becomes blurred, discontinuing the medication usually stops the problem from getting worse.
For an eye doctor in your area, contact an organization such as Eye And Laser Center Of Fort Collins.