The ocular safety of hydroxychloroquine

The insert currently supplied with hydroxychloroquine states that patients should have an initial ophthalmological assessment and then regular assessments every 3 months. The rheumatologist should expect a report from the ophthalmologist, which includes a corneal assessment of tissue dose, a reference to visual field defects if present on the Amsler grid, and a comment concerning the status of the patient's color vision. Daily dose is more important than duration of dose, regarding maculopathy. The visual prognosis of retinopathy is excellent if the diagnosis is made at an early stage of the disease. This report suggests that ophthalmological review need only occur initially and on a yearly basis if the daily dose of hydroxychloroquine is less than 6.5 mg/kg/d and the duration of therapy is less than 9 years.