Plaquenil and the Eyes (hydroxychloroquine)
A lot of people are on plaquenil (the generic name is hydroxychloroquine). This is a medication that is usually used for lupus, sjogren's disease, rheumatoid arthritis and other autoimmune diseases. An autoimmune disease is one where the body attacks itself. It is very important to see your ophthalmologist or eye doctor when you are on this medicine because it can cause a problem with the retina. The medicine can concentrate in the pigment in a place called the macula in the back of the eye. This is the area where light is focused--if your eye was a camera, this would be the film of the camera. This concentration can result in damage to the photoreceptors and retinal pigment epithelium resulting in vision loss (these are two layers of the retina). The classic finding is a bulls eye maculopathy--loss of the vision in a circle around the very center of sight. The problem with this vision loss is that it is not reversible, and it can sometimes progress for a period of time even after the plaquenil is stopped. The good news is that this condition is rare, and it usually occurs after being on the medicine for several years first unless the dose is high or there are kidney problems or other complicating factors. Here at Reveal Eye Care & Surgery, we have the recommended testing equipment to pick up the earliest changes of the disease. By picking up the disease before there is a vision change that is noticeable to the patient, we can usually stop the medication and save the vision before there is any loss that affects quality of life. The newest recommendations from the American Academy of Ophthalmology include obtaining an ocular coherence tomography (OCT) scan of the macula to look for photoreceptor damage, and a 10 degree white-on-white visual field. Here at Reveal Eye Care & Surgery, we have a brand new Cirrus High Definition OCT, and a new Visual field that can do one of the fastest measurements of the peripheral vision. Please call our office to schedule an appointment if you are on plaquenil and have not been tested, or have not been receiving the ideal testing.