Eye Health More Eye Issues & Safety Plaquenil Side Effects on Your Eyes and Vision By Troy Bedinghaus, OD linkedin Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association. Learn about our editorial process Troy Bedinghaus, OD Medically reviewed by Medically reviewed by Johnstone M. Kim, MD on July 19, 2020 Johnstone M. Kim, MD, is board-certified in ophthalmology. He's a practicing physician at Midwest Retina in Dublin, Ohio and previously served as a full-time faculty member at the Wayne State University School of Medicine and the Kresge Eye Institute in Detroit, Michigan. Learn about our Medical Review Board Johnstone M. Kim, MD on July 19, 2020 Print If you're taking Plaquenil to treat an inflammatory condition or malaria, you should be aware of the side effects that may occur to your eyes and vision. Plaquenil (hydroxychloroquine) is in a class of drugs called disease-modifying anti-rheumatic drugs (DMARDs), which are used to decrease inflammation, pain, and joint damage. While today it is used to treat autoimmune conditions, such as rheumatoid arthritis and lupus, it was originally used as an anti-malaria drug. The eye-related side effects are uncommon but severe enough to warrant paying extra attention to what's going on. Eric Audras / Getty Images Hydroxychloroquin Retinopathy In some people, Plaquenil can cause a condition called hydroxychloroquine retinopathy, often referred to as bulls-eye maculopathy. (The condition can cause the appearance of a target, or bulls-eye ring, on the retina surrounding the macula.) Hydroxychloroquine retinopathy is extremely rare and is most often seen in cases where the dosage is high or the patient has been taking it for several years. When it does occur, it can be devastating to your vision. Initially, central vision is not affected, but you may notice a ring of disrupted vision that may interfere with reading. As the disease progresses, it begins to affect central vision and can become life-altering. The changes are permanent, so early detection of this condition is paramount. Testing Most rheumatologists recommend patients undergo a baseline eye examination prior to starting Plaquenil. Because retinal toxicity is much more likely after five to seven years, annual exams should start once you've been on the drug for five years. Some doctors favor more frequent testing, including a full evaluation every 18-24 months during the first five years and annually thereafter. Risk factors include advanced age and having pre-existing retinal disease. Guidelines for Plaquenil screenings have expanded over the years and the technology for detecting retinal changes has improved, as well. Currently, a Plaquenil eye exam should including the following: Dilated retinal examinationRetinal photography (for baseline documentation only)Central computerized visual field testSD-OCT (spectral domain optical coherence tomography) Your doctor may recommend frequent, simple at-home tests in addition to extra eye exams. If you have odd visual changes at any time while taking Plaquenil, see a doctor. How a doctor corrects your vision with glasses or contact lenses A Word From Verywell It pays to be extra vigilant about your vision while taking Plaquenil, but remember that this is a fairly rare complication. Your regular doctor, eye doctor, and pharmacist should be able to answer any questions you may have about your risk or what to look for. Was this page helpful? Thanks for your feedback! Sign up for our Health Tip of the Day newsletter, and receive daily tips that will help you live your healthiest life. Sign Up You're in! Thank you, {{form.email}}, for signing up. There was an error. Please try again. What are your concerns? Other Inaccurate Hard to Understand Submit Article Sources Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy. Shechtman DL, Karpeck PM. New Plaquenil Guidelines. Review of Optometry. 2011;148(4):105-6.