Plaquenil (hydroxychloroquine) is an anti-inflammatory used for some rheumatological conditions. Rarely it can cause retinal toxicity resulting in loss of visual acuity, peripheral vision, and night vision which may be irreversible and may progress even after discontinuing use of the medication.

Early symptoms may include a blind spot in central vision, however patients usually only notice symptoms after they've become severe. Retinal toxciity from Plaquenil is generally attributed to multiple large doses over many years and is rarely seen in the early stages of use. Patients at higher risk may include those who take 400mg or more per day, take a cumulative dose over 1000 grams, use the medication for more than 5 years, suffer from concomitant renal or liver disease, have maculopathy or underlying retinal disease, and are over 60 years of age.

Patients considering taking Plaquenil should schedule  an eye exam before starting treatment. 

Gilenya is used to treat multiple sclerosis and can result in swelling of the central retina 3-4 months in to treatment. Symptoms may not be noticed, but include, blurriness, shadows or blind spots in central visual field, changes in color, and light sensitivity.

Patients at higher risk may include diabetics and those with a history of uveitis.

We recommend patients schedule an eye exam prior to starting treatment, and a follow up appointment within 3-4 months.