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 and omeprazole Plaquenil eye side effects symptoms Purpose of hydroxychloroquine A 57-year-old female presented to the Ophthalmology clinic at UIHC complaining bilateral central photopsias for the past two years. 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. Rash, changes in skin pigment such as darkening or dark spots, hair changes, and muscle weakness. Rarely, hydroxychloroquine can lead to anemia in some individuals. This can happen in individuals with a condition known as G6PD deficiency or porphyria. In rare cases, hydroxychloroquine can cause visual changes or loss of vision. Patients with retinal changes may be asymptomatic initially, or may have scotomatous vision with paracentral, pericentral ring types, temporal scotomas, and abnormal color vision.-Corneal changes including edema and opacities can be symptomless or may cause disturbances such as haloes, blurring of vision or photophobia. They may be transient. 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. Hydroxychloroquine vision changes Hydroxychloroquine retinopathy A review of imaging, PATIENT FACT SHEET Hydroxychloroquine Plaquenil Can plaquenil cause ptosisHydroxychloroquine and ra If you are taking hydroxychloroquine for a long period of time, your doctor will recommend frequent eye exams. It is very important that you keep these appointments. Hydroxychloroquine can cause serious vision problems. If you experience any changes in vision, stop taking hydroxychloroquine and call your doctor immediately. Hydroxychloroquine MedlinePlus Drug Information. Hydroxychloroquine Side Effects Common, Severe, Long Term.. New Plaquenil Guidelines. However, a few systemic medications can cause damage to the eyes with subsequent vision changes. Plaquenil hydroxychloroquine is an anti-malarial medication used to effectively treat rheumatoid arthritis and autoimmune conditions such as systemic lupus erythematosus and Sjögren’s Syndrome. Any change in vision—whatever you perceive as different from normal—should be checked out.” Lyons’ advice to rheumatologists “When taking patient histories, ask about symptoms affecting their vision. Encourage them to talk about any changes.” New Plaquenil dosing guidelines increase safety With Plaquenil related toxicity, the pigment in the macula can change and alter vision by producing blurring and distortion of objects. These changes, if they are going to occur, happen slowly over a long period of time. Your eye care provider can examine the macula and detect subtle changes before you begin to notice any symptoms of problems.