When you are diagnosed with a disease or illness that runs a long course you are not always told explicitly that you will be on the same medication long term, but it is implied. I began down my Hydroxychloroquine (Plaquenil) path in the Winter of 2008. I was advised at the time of the potential for complications with the medication and was not too phased. I am familiar with the protocol that these complications need to be advised, even if the actual likelihood of damage is relatively low.
By the way, have you ever read the possible dangers of taking Paracetamol or Aspirin? They are as potentially damaging as some illicit substances. Just Saying.
As the lesions I develop in my brain frequently grow in the area surrounding how my brain interprets what I see and so I often lose portions of my visual field for milliseconds at a time, I am increasingly conscious of how accurate my eyesight actually is. A few truths about my eyesight need to be clarified here first:
- I am long sighted naturally and have had glasses for reading short distances since I was eight years old.
- I have astigmatisms in both eyes which mean my eye lenses are not curved in the natural way and so light does not meet as it should in my eye, causing starry-visual images rather than round ones.
- Since my incidences of Bell’s Palsy my eyes do not close effectively, symmetrically or wholly. When you blink and your eyelid covers your eye it moistens the many minuscule muscles on within the eye. The eye needs to be moist so the muscles can move with a little friction as possible. Dry eyes hurt and over time the muscles begin to deteriorate, hence the eyesight becomes less accurate or strong. This is more so in my right eye than my left, causing a disparity in the strength of my eyes from left to right.
As it is you can see I’m in a delicate situation with my eyes and I am an active responder in the regular check-ups I have at my Optometrist.
First of all I would like to discuss Hydroxychloroquine with you, the use and the risk involved with it.
Brand name: Plaquenil Sulfate, Quineprox
Treatment uses: Originally devised as an antimalarial, it was found to also effectively assist in the maintenance and regulation of some rheumatic illnesses, autoimmune illnesses and various types of Lupus. Drugs.com
Plaquenil toxicity: A concern with patients who take this medication long-term but for how long this is exactly depends on individual factors. The eventuation of this side effect is rare but irreversible if it occurs. It is important those who take this medication are aware of this risk and they take steps to monitor their eyesight from the start of ingestion.
The risk of this outcome increases as the individual nears or exceeds an accumulative dosage of 1000g. The typical lowest dosage of this drug is 200mg per tablet and patients may be prescribed 200mg or 400mg daily, or more, dependent on their illness and situation. The drug does not exit the body as readily as some other medications, hence the measure of cumulative ingestion over time.
How to be strategic and practical in monitoring your eyesight on this medication: The wisest way to practically assess if this medication is causing your eyesight damage is to have a complete baseline examination by an Ophthalmologist when you begin taking this medication, or as soon as you discover this risk. From the baseline, you can presumably use a regular Optometrist to undergo 6 monthly checks, as well as 2 yearly Ophthalmologic checks. It is important you attempt to attend the same surgery and/ or doctor each time so they can measure any variances.
The baseline established where your eye health is when you begin the Hydroxychloroquine treatment is important so that it can be assessed if the medication is impacting you in any other way or at a rate that is not expected.
It is possible to far exceed 1000g without the eyesight of an individual being impacted, if at all, so there should be no need to panic unnecessarily. Add to this the practical knowledge that if you monitor it regularly and establish a baseline with both your Optometrist and Ophthalmologist, you can be well ahead of the game if you indeed need to be at all.
Information on this condition can be accessed directly at the following site by American Academy of Ophthalmology.