"Look at everything—every time" is a mantra many of us have humming in the background as we go through our clinical day. Accordingly, providing screening examinations for high-risk medications, such as hydroxychloroquine, is a natural service for our profession. Plaquenil manufacturer change side effects What is hydroxychloroquine made of What are some of the side effects of plaquenil The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. In 2002, the American Academy of Ophthalmology AAO established ocular examination guidelines for screening patients on Plaquenil therapy. Testing included a comprehensive eye exam that consisted of an assessment of the posterior segment with careful evaluation of associated macular changes or signs of retinal disease. 4 Baseline fundus. Minimum treatment guidelines recommend that every patient taking Hydroxychloroquine Plaquenil should have an annual eye exam after being on the medication for 5-years. But because your vision is priceless, Stonewire recommends annual eye health exams to all our patients on these medications and potentially we may escalate the frequency to every 6-months after 5-years. The retinopathy is hallmarked by parafoveal changes within the retina. Hydroxychloroquine is an analogue to the much older drug chloroquine. Hydroxychloroquine is most frequently used for the management of lupus and rheumatoid arthritis; however, it is now being applied to treatments in adjunctive cancer therapy, diabetes, and heart disease. Protocol for hydroxychloroquine screening optometry AAO Screening Guidelines for Plaquenil, New Plaquenil Guidelines - Plaquenil pain reliefNitrofurantoin and hydroxychloroquine Jan 15, 2016 In the past decade or so, SD-OCT studies have become popular as a means of objectively assessing early retinal damage with a high resolution on the order of just a few microns. In 2011, SD-OCT was added to the American Academy of Ophthalmology’s clinical guidelines for detecting hydroxychloroquine and chloroquine toxicity. 22 Managing the Medicine Cabinet -. Stonewire Optometry-Blog-Hydroxychloroquine Why you need an.. Recommendations on Screening for Chloroquine and.. The new guideline on screening for hydroxychloroquine and chloroquine retinopathy is written in response to evidence from the United States that shows that hydroxychloroquine retinopathy is more common than previously recognised. Implementation of the guideline’s recommendations will prevent iatrogenic visual loss. Screening Protocol. Proper protocol implementation requires knowing when to evaluate patients on Plaquenil and what ancillary tests to perform. To start, have patients complete a questionnaire that answers the following Are you currently taking Plaquenil? If yes, when did you start? What is your current dosage? What is your current weight? Once retinal toxicity from hydroxychloroquine occurs, it is thought that the retinal changes are permanent and the disease can progress even if hydroxychloroquine is stopped for 1 to 3 years. Newer techniques for evaluation of retinal disease have been developed and these techniques can detect retinal toxicity earlier.