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 effect on lysosomes Ra mediciane hydroxychloroquine Other possible screening tests color vision testing, visual field 10-2 central field testing One of the Required Standard Testing Items Required Standard Testing Items this is the most important thing you can read on this post because this is the big area where guidelines have changed. The screening tests. Baseline assessment. Within one year of starting hydroxychloroquine, you may be invited to a baseline screening. appointment. The purpose of this assessment is not to detect toxicity from hydroxychloroquine, but instead to ensure there are no other problems that will make screening for toxicity difficult in the future. Revised recommendations on screening for chloroquine and hydroxychloroquine retinopathy. Marmor MF1, Kellner U, Lai TY, Lyons JS, Mieler WF; American Academy of Ophthalmology. Author information 1Eye Institute at Stanford, Stanford University, Palo Alto, California, USA. 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. Eye screening tests for plaquenil guidelines Despite Plaquenil dosing recommendations, retinal toxicity., Eye screening for patients taking hydroxychloroquine. Can plaquenil cause metallic tasteChloroquine vaccinePlaquenil coupon cardPlaquenil skin pigmentationHydroxychloroquine side effects psoriasis Newer guidelines state that daily dose 5mg/kg of real weight/day can lead to toxicity. Retinal toxicity is irreversible and can progress after cessation of hydroxychloroquine, thus early screening is important to limit potential vision loss. Baseline screening and annual screening after five years is recommended. Hydroxychloroquine Plaquenil Toxicity and.. Revised recommendations on screening for chloroquine and.. What can Hydroxychloroquine Plaquenil do to my eyes?. Eye doctor when you are on this medication so regular visual screening tests can be performed. If you are pregnant, considering becoming pregnant, or lactating, please discuss this with your doctor before taking this medication. However, hydroxychloroquine has been shown to be safe during pregnancy and breast feeding. Taking hydroxychloroquine. If you are already on the screening programme for hydroxychloroquine retinopathy, and your last screening tests were normal, it is very unlikely that your symptoms are due to hydroxychloroquine retinopathy. The next screening visit does not need to happen sooner than planned. However, 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.