In this article, new recommendations were made that changed the previous monitoring paradigm. More importantly, it has repositioned hydroxychloroquine from one of the safest medications that rheumatologists use to a drug that can have potentially significant ocular morbidity (if used in doses greater than 5 mg per kilogram and or for prolonged periods of time). Buy chloroquine online Is celebrex better than plaquenil 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 the medication can be stopped if toxicity occurs. Baseline retinal examinations have long been recommended for patients beginning treatment with hydroxychloroquine HCQ, but it is unknown how well this guideline is followed. We investigated baseline eye examinations among US SLE patients enrolled in Medicaid in whom HCQ treatment was newly initiated. Methods Baseline examination. At the initiation of treatment with hydroxychloroquine, the prescribing physician should refer the patient to an ophthalmologist. During the initial examination, it is recommended that the patient receive 1 a thorough ocular examination documenting any preexisting conditions, The previous AAO guideline recommended screening every 12 months. It has become fairly common practice for most rheumatologists to recommend that patients being treated with hydroxychloroquine be seen for formal visual field evaluation once or twice a year to monitor for retinal toxicity. Hydroxychloroquine baseline eye exam Eye exam / Plaquenil -, Baseline Retinal Examinations in Patients With Systemic. Plaquenil wonder drugHydroxychloroquine 200 mg tab priceStopping plaquenil during pregnancyWhy take hydroxychloroquine with methotrexate Baseline Examination All patients should have a baseline ophthalmologic examination within the first year of initiating HCQ or CQ therapy with thorough risk factor assessment and fundus examination of the macula to rule out underlying disease. Baseline visual field and SD OCT are recommended if abnormalities are present e.g. macular lesions. Hydroxychloroquine Plaquenil Toxicity and Recommendations.. Hydroxychloroquine-Induced Retinal Toxicity - American.. RCOphth guideline Hydroxychloroquine and Chloroquine.. May 24, 2017 Obtain a baseline eye exam within the first year of starting hydroxychloroquine to document any complicating eye problem. Annual screening beginning after 5 years of use. Sooner if there are major risk factors. Check the dose of hydroxychloroquine based on your weight at your doctor’s appointment. OCT imaging This test makes a detailed, three-dimensional image of your eye. Your ophthalmologist can use this image to look for early retinal damage. 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. Of course the aim is avoid drug related retinal toxicity, which on ophthalmic examination, appears as the classic Bull’s eye change affecting the macula. Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years.