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. Malarone chloroquine resistance Sarcoidosis treatment usmle hydroxychloroquine The American Academy of Ophthalmology released an updated set of screening recommendations for hydroxychloroquine Plaquenil and chloroquine to account for the many studies that have shown the effects of these medications on the retina 1. It succinctly makes the case for screening, and 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. The previous AAO guideline recommended screening every 12 months. 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. 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 plaquenil screeniing Plaquenil Risk Calculators, My Take on New Ocular Screening Guidelines for Plaquenil. Can you take flexeril with plaquenil Plaquenil hydroxychloroquine used for lupus and rheumatoid arthritis can cause toxicity to the retina leading to vision loss. In this episode of A State of Sight, Isaac Porter, MD explains how. Plaquenil screening eye exam, hydroxychloroquine toxicity.. Hydroxychloroquine Plaquenil Toxicity and.. The Risk of Retinal Toxicity with Plaquenil. Hydroxychloroquine is a well tolerated medication for various rheumatologic and dermatologic conditions. Its main side effects are gastrointestinal upset, skin rash, headache, and ocular toxicity. Within the eye, hydroxychloroquine negatively impacts the cornea, ciliary body, and retina. Plaquenil can prove toxic to the retina, threatening the vision. Regular eye examinations are essential for those patients taking plaquenil because over time the retina can become damaged beyond repair. Regular medical monitoring is the only way to ensure that toxicity is not occurring. Jan 18, 2019 Hydroxychloroquine Plaquenil was originally used to treat malaria and is now used mostly to treat rheumatological and dermatological diseases. Its most frequent use now is for Rheumatoid Arthritis RA and Lupus and is often very effective in mitigating the joint and arthritic symptoms these diseases can cause.