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. Metoprolol and plaquenil interaction Brazil nuts and plaquenil 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. 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 Eye Exam Before Starting Treatment. If a person is going to be treated long-term with Plaquenil, they need to have a thorough dilated eye exam with best corrected visual acuity, central visual field, color vision, and dilated examination of the retina. The medication can cause retinal toxicity which is dose related. 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 How Do Ophthalmologists Look for Plaquenil Damage? - American Academy., Hydroxychloroquine And Chloroquine Screening 2016 AAO. Taking two plaquenil instead of 1.5Side effects of plaquenil on pregnancyChloroquin vs quinineChloroquine rheumatoid arthritis 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 or Hydroxychloroquine - Total Eye. Plaquenil Eye Exams - Catalina Eye Care. Dilated Fundus Exam. The optic nerves appeared healthy with a 0.3 cup-to-disc ratio. There was mild paracentral depigmentation of the RPE in the macula that spared the central fovea OU. The vessels and peripheral exam were normal OU Figure 1. There was no posterior vitreous detachment, retinal tears, or retinal detachments. Ancillary Tests 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. The doctors of Wellish Vision Institute are experienced in testing patients for early signs of Plaquenil side effects. Thorough tests include visual acuity examinations, distortion and color vision tests, central field of vision tests, and a detailed dilated retinal exam. If signs of abuse or side effects are detected.