Diabetic and Plaquenil Evaluations
Patients with diabetes are at an increased risk of developing eye diseases that can cause vision loss and blindness, such as diabetic retinopathy, cataracts and glaucoma. These and other serious conditions often develop without vision loss or pain, so significant damage may be done to the eyes by the time the patient notices any symptoms. For this reason it is very important for diabetic patients to have their eyes examined once a year. Diagnosing and treating eye disease early can prevent vision loss. It is also important to maintain a steady blood-sugar level, take prescribed medications, follow a healthy diet, exercise regularly and avoid smoking.
Plaquenil or hydroxychloroquine is a very useful medication for some patients with auto-immune diseases like rheumatoid arthritis or lupus. The medication is generally safe but because toxicity can cause permanent decrease in vision, regular specialized thorough exams are necessary. The risk of toxicity increases with daily dose, total dose, dose per body weight, and poor kidney function. Early plaquenil toxicity of the retina can best be detected by autofluorescent fundus photography, by visual field testing of the central 10 degrees of sight, and by an advanced device called a spectral domain OCT, each repeated regularly over time.