Plaquenil (Hydroxychloroquine) is used to dampen inflammation
in some forms of arthritis, especially rheumatoid arthritis and lupus. Plaquenil
is usually used for long term disease control, rather than in the short term to
control active bursts of inflammation. Plaquenil has important but uncommon side
effects that may affect your eye.
does Plaquenil affect your eyes?
The most important affect of Plaquenil
on your eye is to damage the retina at the back of your eye. Fortunately, this
is very uncommon and generally only occurs in patients on high doses or patients
with bad kidney function. This sort of retinal damage may result in patchy loss
of central vision or patchy loss of vision just close to the centre of your vision.
There are a number of other much less important side effects of Plaquenil, including
changes in the cornea and changes in the eyelids. To be at risk of eye problems
from Plaquenil you need to be on quite a high dose. The dose that you can safely
tolerate depends on your size. If you weigh less than 30kg, then you may run in
to problems on just one tablet a day. If you weigh less than 60kg (around 9 ½
stone) then you may be at risk of eye problems on two tablets daily.
can I do to ensure my eyes are not affected?
It is important to promptly
report any changes in vision, especially any changes in your central vision whilst
you are on Plaquenil. It is also useful to check your central and near central
vision regularly. It is recommended that you check you vision on an Amsler chart
weekly (see below). You do this by looking at the black dot in the centre with
one eye at a time and noticing if there are any gaps or irregularities in the
straight lines around the black dot. If there are any changes then you should
tell your rheumatologist or your eye doctor promptly. The vast majority of patients
on Plaquenil get absolutely no eye problems and you should not be unduly worried
or concerned. If you have a good response in your arthritis to the Plaquenil then
the benefits of a Plaquenil almost certainly outweigh the small risks to your
eyes. So long as you are careful with your eyes, then there are no reasons that
you should develop any problems in the long term.
- Sit in an area with good
lighting, wear your reading glasses and look at the the grid at a comfortable
Cover one eye
Look directly at the centre dot. While looking directly at the dot note whether
all lines of the grid are straight or if any areas are distorted, blurred or dark.
- Repeat the
test with the other eye
If you experience:
your ophthalmologist immediately!
or curvy lines
or spots in some areas of the grid