Plaqueneil Vision Tests | Arthritis Information

When getting eyes checked for Plaquenil vision problems, does

your eye doctor dilate your eyes? More specifically, do you

know which exact test they perform? Seems my Rheumy and

Optometrist disagree on what should be done. My optomerist

feels my eyes should be dilated and my rheumy

seemed surprised.

I hope you are actually seeing an ophthamalogist for your eye exam not an optomatrist. The MD is far better qualified to diagnose and treat the eye issues that can accomapany RA and the treatment of RA This is not to put down optomotrists but their specialty is not diagnosing eye diseases but rather dealing with issues leading to glasses

Just like I would defer to my rheumatologist about my RA and RA meds I would defer to my ophthamalogist as to what is needed for a through eye exam My eyes were always dialated and the exam should also include a field of vision test

As toxicity occurs in the retina and to examine the retina the iris needs to be dilated, my opthamalogist always dilates my eyes.

IU Opt/systemic pharmaceuticals provides the following:

Testing should include:

Visual acuity
Amsler grid (red on black may be more sensitive)
Central visual field analysis with 10-2 threshold VF
Color vision testing including blue/yellow (Waggoner, extended Ishihara)
Dilated evaluation of macula
Multifocal ERG (very sensitive!) when needed
Report to rheumatologist
Discontinue when possible at earliest sign of trouble (remember can progress after d/c)

Chloroquine maculopathy

Plaquenil Follow-Up

If no problems and on 200 mg/day, patient can be seen yearly. If on 400 mg/day, see patient every 6 months if no problems, more frequently if issues arise. Communication with the prescribing physician is the key!

My opthamalogist always dilates my eyes.It is interesting to note that the ACR did change its recommendation for eye exams for plaquenil in the 2008 update

If the patient is in the low-risk category (e.g.,

no liver disease, no concomitant retinal disease, and age

60 years) and these examination results are normal, the

American Academy of Ophthalmology recommendation is

that no further special ophthalmologic testing is needed

for the next 5 years. For patients in the higher-risk category,

an annual eye examination is recommended by the

American Academy of Ophthalmology (239).

[QUOTE=buckeye]It is interesting to note that the ACR did change its recommendation for eye exams for plaquenil in the 2008 update

If the patient is in the low-risk category (e.g.,

no liver disease, no concomitant retinal disease, and age

60 years) and these examination results are normal, the

American Academy of Ophthalmology recommendation is

that no further special ophthalmologic testing is needed

for the next 5 years. For patients in the higher-risk category,

an annual eye examination is recommended by the

American Academy of Ophthalmology (239).

[/QUOTE]

Interesting...I think I'd rather have my yearly testing just to make sure, though.My opthomologist always dialates my eyes. They have me do other tests as well before they dialate but not sure if its for Plaquenil or just regular eye checks. Reading the numbers /letters in different sizes, color tests and just asks general questions. When my eyes are dialted he looks with a light back and forth along my eye and spends some time really looking to make sure they look ok.Great insight. Thanks for all the feedback!I was told that the dilation is with the reg. checkup. The plaquenil affects you vision field, so that is a totally different test. You look into this little machine and lights flash all around. You push a button each time you see a light.

Since I am on a fairly high dose, I get it done every 6months. But, I also have a ton of RA involvement in the eyes.

I always get dilation and I also see an opthomologist. I also get my field vision test every 6 months.

The Ophthomologist always dilates my eyes too. He also said my eyes look so good that he hates making me come in once a year, but my RD insists.