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. Chloroquine generic Chloroquine failure deaths in africa Therefore, it is extremely important that patients using Plaquenil follow their doctor's recommendation for regular eye exams. At Solomon Eye Physicians and Surgeons, we recognize the importance of these exams and are extensively trained and experienced in detecting retinal toxicity due to the use of hydroxychloroquine. Plaquenil is a drug used to treat Rheumatoid Arthritis and Systemic Lupus Erythematosis. It is a very good drug and gives many patients significant relief from their symptoms. Plaquenil related eye complications are not common. Plaquenil can produce pigment changes in the macula of the retina. Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil and be re-examined in the future depending on their risk for developing the condition. Risk factors include advanced age and having pre-existing retinal disease. 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. Plaquenil dilated eye retinal exam Retinal Imaging Purpose, Procedure, Risks, Resutls, Conditions Plaquenil-related Eye Problems Eugene Eye Care Hydroxychloroquine mechanism of action drunkbank Eye care professional report for Dilated Retinal Eye DRE exam Use this completed form to communicate results to your patient’s primary care provider. Eye care professional report for Dilated Retinal Eye DRE exam. Plaquenil Side Effects on Your Eyes and Vision. Plaquenil How I’m okay with it all — The Eye Doctor - Dr.. Bull’s Eye Retinopathy Early macular toxicity can cause stippling or mottling of the RPE Next, granular pigmentation and loss of the normal foveal reflex can occur It’s believed but not proven that if early macular changes are detected and the medication is stopped, any toxicity that has occurred can be reversed.1 If the maculopathy continues to progress, concentric zones of. 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. Furthermore, the advent of novice sensitive diagnostic modalities has led to a revision of the recommended guidelines for patients using Plaquenil see “2011 Plaquenil Screening Tests”. 7. A dilated fundus examination is critical in detecting and documenting established macular or retinal disease; however, due to low sensitivity, it should not be used as a screening test alone.