Plaquenil (Hydroxychloroquine) Eye Screening

Hydroxychloroquine (Plaquenil) is a valuable medicine for lupus, rheumatoid arthritis and other conditions. Over years of use, it can damage the retina. This toxicity causes no symptoms early on and the damage is permanent, so regular screening is essential.

Who needs screening

Anyone taking hydroxychloroquine or chloroquine. The American Academy of Ophthalmology recommends:

• A baseline exam within the first year of starting the medicine
• Yearly screening after 5 years of use for people at low risk
• Yearly screening sooner for people with higher risk

Higher risk factors

• A daily dose above 5 mg per kilogram of your actual body weight
• Long duration of use
• Kidney disease
• Use of tamoxifen
• Existing retina or macula disease

How we screen

Screening uses sensitive tests that can show early changes before you notice anything: OCT imaging of the retina and automated visual field testing, with additional tests when needed. Patients of Asian descent often show early changes in a different area of the retina, so we adjust testing accordingly.

What happens if changes are found

We share the results with your prescribing doctor, who decides with you whether to change or stop the medicine. Finding toxicity early limits how much vision is affected.

Common questions

Should I stop Plaquenil to protect my eyes?

No. Do not stop or change the dose without talking to your prescribing doctor. Screening lets you continue the medicine safely and catches problems early.

Will I notice symptoms if the medicine affects my eyes?

Usually not until the damage is advanced, which is why screening matters. Later symptoms can include trouble reading or missing spots near the center of vision.

Can you send results to my rheumatologist?

Yes. Bring your prescriber’s name and the dose you take, and we will share the report.