Hydroxycholoroquine and Chloroquine Screening in London

Monitoring your sight whilst on treatment

Hydroxychloroquine is a medication that is used effectively in the treatment of a number of long term inflammatory disorders affecting the joints and the skin. It is a generally a safe medication that is effective especially when compared to some of the newer medications that are anti inflammatory. Some patients however, on Hydroxychloroquine or a similar medication called Chloroquine can develop vision loss due to the long term affect of the Hydroxychloroquine on the eye and in particular the retina.  The effect on the vision can be permanent. The retina is a layer at the back of the eye that senses the light and sends the image to the brain so that people can see.  The effect of Hydroxychloroquine on the retina and the vision can take years to establish is known as Hydroxychloroquine retinopathy.

 

The risk of Hydroxychloroquine retinopathy developing increases the longer a person is taking the medication. Hydroxychloroquine retinopathy rarely affects individuals how have been taking it for less than five years. 8% of those taking Hydroxychloroquine for more than 5 years may have some evidence of Hydroxychloroquine retinopathy. 20 to 50% of people taking Hydroxychlorquine for more than 20 years may have signs of Hydroxychloroquine retinopathy.

In the later and more advanced stages of Hydroxychloroquine retinopathy, people can develop some loss of their peripheral vision. As it progresses the central vision then may become affected as well.  It can result in the loss of sight in both eyes permanently which would have a significant impact on the quality of life and activities such as reading and driving. With Hydroxychloroquine retinopathy it is less likely that all the visual field would be lost even in the advanced stages.  That said, once there is a noticeable loss in vision from Hydroxychloroquine retinopathy there is damage to the retina that is permanent and the damage can continue with further visual loss even if the medication is stopped.

 

Hydroxychloroquine retinopathy may be detected earlier by looking at the layers of the retina at the back of the eye with photographs, a specialised OCT scan of the retina and by assessing a person's visual field. These tests with their information, when used collectively, can be used to detect Hydroxychloroquine retinopathy before someone notices an effect on their vision so that it can be detected much sooner.

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