There is a rare but known link between the use of Hydroxychloroquine and Quinine and vision loss. These medications are used widely in many auto immune conditions. Less than one percent of patients using these medications will have visual problems relating to their use.
The Royal College of Ophthalmologists (RCOphth) recommend the regular monitoring of people who have been taking Hydroxychloroquine for more than 5 years. Currently there is no formal monitoring service in Wales. There is also not the capacity for this monitoring to be carried out in the Hospital eye service which is already over stretched. It is unlikely that a patient has Hydroxychloroquine toxicity if they do not have any problems with their vision.
The Welsh Sub-committee of the RCOphth is working with Welsh Government and our optometrist colleagues to establish a community based monitoring service. As of yet there is no scheduled start date, however when it does start it will be the responsibility of the clinician prescribing Hydroxychloroquine to refer a patient to the service. In the mean time patients should continue to undertake regular sight tests with their local optometrist. Although the tests they carry out may not be the same as those in a structured monitoring service they are skilled enough to determine if there is any abnormality present. Only if such an abnormality is found should they be referred to the hospital.
If you have any concerns about a patient’s vision please inform them to contact their Optometrist in the first instance.