Retina Screening for Hydroxychloroquine Users – What You Need to Know

If you take hydroxychloroquine for lupus, rheumatoid arthritis, or malaria prevention, you’ve probably heard that the drug can affect your eyes. The good news is that early detection through regular retina screening can keep your vision safe. In this guide you’ll get the basics of why the test matters, how often you should have it, and what to expect during the exam.

Why Retina Screening Matters

Hydroxychloroquine can build up in the tiny cells of the retina over time. When those cells start to break down, you might notice blurry spots, difficulty reading, or loss of peripheral vision. The damage is often painless, so you may not notice it until it’s advanced.

Studies show that when screening is done before any symptoms appear, doctors can adjust the dose or switch meds, and most people keep their eyesight. The American Academy of Ophthalmology recommends a baseline exam within the first year of treatment, followed by yearly checks after five years of use—or sooner if you have risk factors like kidney disease, high body weight, or a long treatment history.

How to Get Your Screening

First, ask your rheumatologist or primary care doctor for a referral to an eye specialist who does retinal imaging. The most common tests are:

• Optical Coherence Tomography (OCT): This quick, painless scan creates a cross‑section image of the retina, letting the doctor spot early thinning or damage.
• Fundus Autofluorescence (FAF): This uses a special light to highlight areas where the retina is stressed.
• Visual field test: You’ll look at a screen and press a button when you see lights, measuring peripheral vision.

The whole appointment usually takes 20‑30 minutes. No dilation is required for OCT, but some doctors may dilate your pupils to get a clearer view of the back of the eye.

If the test shows any warning signs, your doctor will likely lower the hydroxychloroquine dose or suggest an alternative drug. In many cases, stopping the medication early prevents permanent vision loss.

Don’t wait for symptoms to appear. Schedule your baseline exam within the first year of starting hydroxychloroquine and set a reminder for yearly follow‑ups. Keep a copy of your results; they help track subtle changes over time.

Bottom line: Retina screening is a simple, low‑risk step that protects your vision while you benefit from hydroxychloroquine’s anti‑inflammatory power. Talk to your healthcare team today, get the test scheduled, and stay on top of your eye health.