She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine (Plaquenil) 200mg bid (6.5mg/kg) for 10 years, which was stopped one year prior to presentation. Plaquenil and bypass surgery Pharmacokinetics of chloroquine Malaria tablets chloroquine and proguanil side effects Wrong Hydroxychloroquine Dose Is Common, Putting Eyes at Risk Up to half of patients treated with the arthritis drug hydroxychloroquine Plaquenil are prescribed more than the recommended maximum amount, according to new research. I also had to get a baseline exam prior to taking the Plaquenil and my rheumy was very serious when he said not to take them until I had the exam. They have to examine you to see if you have anything of concern that they can determine that is NOT caused by Plaquenil which is why the baseline exam is important. Diagnosis Hydroxychloroquine-induced retinal toxicity Discussion. Chloroquine CQ and hydroxychloroquine Plaquenil HCQ have been used for many years, initially for the treatment of malaria but now more commonly for the treatment of inflammatory diseases such as rheumatoid arthritis and lupus 1. Review of systems: Blurred vision, halos, dry eye, dry mouth, gastroesophageal reflux, joint pain Pupils: Reactive to light in each eye from 5 mm in the dark to 2 mm in the light. Extraocular movements: Full, both eyes (OU) Confrontation visual fields: Full OU Intra-ocular pressure The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. Past Ocular History: None Medical History: Sjogren syndrome and inflammatory arthritis, supraventricular tachycardia, anxiety, depression, peptic ulcer disease Medications: prednisone, methotrexate, amitriptyline, ranitidine, estradiol, tizanidine, diltiazem, Restasis Allergies: codeine, droperidol Family History: heart disease, arthritis, cancer Social History: occasional alcohol but no tobacco or intravenous drug use. Name for plaquenil eye exam Plaquenil - Wellish Vision Institute, Eye exam / Plaquenil - Can plaquenil lower antibodies to thyroidPlaquenil pill sjogren'sHow long does plaquenil take to work Multifocal ERG This test looks at cells in the retina called rods and cones. The test measures how well these cells respond to light. It can find retinal damage from Plaquenil. A special camera takes pictures of the retina. Photos show damaged areas as small spots of light. How Do Ophthalmologists Look for Plaquenil Damage.. Hydroxychloroquine Plaquenil Toxicity and Recommendations for Screening. Plaquenil Eye Exams - Catalina Eye Care. 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. Remember, any patient who is at a high risk for Plaquenil toxicity should be examined on an annual basis following the baseline exam. 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. Multifocal Electroretinopathy measures electrical responses of various cell types in the retina. It is thought that although the bull’s eye seen on ophthalmic exam represents a disruption of the pigmented part of the retina, it is the photoreceptors that are the targets of hydroxychloroquine toxicity.