Plaquenil can be a game-changer for patients who suffer from inflammatory conditions in dermatology and rheumatology. Before beginning plaquenil/hydroxychloroquine treatment, your physician will ask you to get a baseline screening from an optometrist or an ophthalmologist. This exam is NOT considered routine and will likely be covered by your medical insurance. A routine examination is NOT adequate for assessing retinal health for plaquenil screening. There are a few other tests required.
This exam will include a thorough eye health examination, dilation of the pupils, a specific visual field test specially for the macula, and usually a spectral domain (high-definition) OCT.
The visual field test is called a 10-2 visual field, and specifically covers the macula only. It is ultra-sensitive for picking up the very subtle changes that can occur with plaquenil toxicity. A baseline is important because the test can pick up variations of normal – sometimes people can have a few areas of decreased vision that are NOT due to plaquenil. Having a proper baseline sets the practitioner and the patient up for early detection later down the road. Spectral Domain optical coherence tomography (HD-OCT) is the most common objective test performed for plaquenil screening. This test is so sensitive that it can detect if a single cell in the retina is out of place. This test is not to be confused with standard OCTs, which are not as sensitive to detecting cell loss.
