29: Hydroxychloroquine – Potentially toxic, potentially blinding

One of the side-effects for patients who take hydroxychloroquine, or chloroquine, can be retinal toxicity. The drug is usually taken to help treat rheumatic disorders, but around 7.5% of people who take hydroxychloroquine for over five years are thought to develop retinopathy. That’s why regular monitoring of the eyes is essential. Typically, monitoring takes place in secondary care, however primary care optometry can now play a more useful role – and optometrists can help to highlight the first stages of decline earlier. In this episode, Michelle Hanratty asks Sharon Beatty, an optometrist, and Sonia, a patient, about a pilot monitoring scheme in optometry across the Cardiff and Vale University Health Board in Wales. Michelle also dives deeper with Rhianon Reynolds, a consultant ophthalmologist within the Aneurin Bevan University Health Board. They discuss how the Royal College of Ophthalmologists guidelines changed in 2020 – away from baseline monitoring – and towards more targeted tests. The AOP has also recently updated its advice on community monitoring for patients who take hydroxychloroquine.  This episode was suggested by Janice McCrudden, an IP optometrist in Northern Ireland, who explains to Michelle why she was surprised to hear about the rapid deterioration of a patient’s ocular health.  This episode covers the GOC domains of Professionalism and Clinical Practice. Docet - dedicated to providing quality optometric education and professional development.