Eye care guide
Plaquenil (hydroxychloroquine) and eye screening
Medical reviewer Mr Mohamed Mohyudin· Last recorded site review
About this review
This page inherits the site’s previous review record. A separate, current article sign-off has not yet been recorded.
Why screening is needed
Retinal toxicity is uncommon but can cause permanent central vision loss if missed. Risk rises with higher doses, long duration, kidney disease and tamoxifen use. Screening finds early changes before you notice them, allowing dose review or stopping the drug with your rheumatologist.
Recommended schedule
Guidelines evolve, but most programmes include:
- Baseline assessment within the first year of starting, or before if possible
- Annual screening after five years of use, or sooner if high risk
- OCT scanning of the macula and at least one visual field test
- More frequent checks if early changes appear
At the screening visit
You may have vision checks, OCT scans that map retinal layers, and visual field tests that detect small blind spots. Dilation is sometimes used. Bring your drug dose history and other medicines.
Between screenings
There is no proven home test to replace clinic screening. Report new difficulty reading, blurred central vision, distorted lines or unusual light sensations to your rheumatologist and eye team between routine visits.
Frequently asked questions
Can I keep taking Plaquenil if screening is normal?
Yes — regular screening is designed so most people continue their rheumatology treatment safely. Abnormal results are reviewed with your rheumatologist.
Does Plaquenil always damage the eyes?
No. Most long-term users never develop retinal toxicity, but screening is essential because damage can be irreversible once symptoms appear.
Who performs Plaquenil screening?
Optometrists or ophthalmologists familiar with current guidelines. Ask for OCT and visual field testing, not vision alone.
Trusted sources
For general background, these organisations provide eye-health information. This list is further reading, not a record that they reviewed this article.