Hydroxychloroquine Screening is offered at our Ashford practice. Your GP/Rheumatologist will refer you to us if needed. We will need you to bring the following;
- We require your weight (in kg if possible)
- List of medication (including HCQ dosage)
- Copy of your last spectacle prescription or bring reading glasses (for trial lens when doing visual fields)
- Dilation may be required (try not to drive to the appointment)
- Light sensitive after dilation – bring sunglasses if possible
Hydroxychloroquine is a medication used to treat several conditions including rheumatoid arthritis, systemic lupus erythematosus, some skin conditions (especially photosensitive ones) and others that involve inflammation.
Your doctor has prescribed hydroxychloroquine to help manage your condition. It is a very safe and effective drug but, like all medicines, it can cause side effects.
Hydroxychloroquine Retinopathy
It is known that some people who take hydroxychloroquine for more than five years and/or in high doses are at increased risk of damage to their retina, the light sensitive layer of cells at the back of the eye. This is known as retinal toxicity or retinopathy. Severe retinopathy, especially in the central area called the macula, causes significant, irreversible sight loss.
For this reason the NHS now offers patients taking hydroxychloroquine regular eye health checks to screen them for signs of retinopathy.
Screening for Hydroxychloroquine Retinopathy
The aim of screening is to detect the earliest definitive signs of retinopathy before a patient notices any symptoms. It is expected that you would have to take hydroxychloroquine for at least five years before early signs can be detected. Because of this you will be invited to take part in the screening program.
The Screening Tests
There are several tests used to screen your eyes for signs of retinopathy. They all involve different types of imaging of the retina and are non-invasive (they do not cause pain and do not risk damaging the eye in any way).
At the first, or ‘baseline’ screening appointment you will have two tests. The first is a colour photograph taken of the surface of your retina, called a fundus photograph. The second is a scan that provides a cross sectional image of the various layers of your retina. This is called an Optical Coherence Tomography (OCT) scan.
You may also be offered a scan that detects abnormal levels of a substance called lipofuscin in the retina, which may be an early sign of disease. This test is called fundus autofluorescence (FAF) imaging. In all these tests you will be seated in front of a large, camera-like machine with a chin rest. You may have several photographs and scans done on each machine to obtain good images of a large part of your retina. Before the tests you will be given eye drops that temporarily widen (dilate) your pupils. This is to allow more light into the eye to give a better view of your retina.
If there is any sign of retinopathy you will be offered another test called a visual field test. A visual field test measure the area of your vision. During this test, one eye is tested at a time while the other is temporarily covered with a patch. You will be seated in front of a machine called a perimeter and asked to look at a fixed spot inside the machine. Points of light will flash in various positions inside the perimeter. When you see a point of light you press a button. This tests takes about 5 minutes per eye.
Your Results
All the tests will be assessed by an ophthalmologist (hospital eye doctor) after you have left the clinic. A report will be sent to you, your GP and/or the hospital doctor who prescribed hydroxychloroquine.
Should you have any queries or need to rearrange your appointment please contact the Ashford practice on 01233 620597.
