![]() Long term plaquenil users on high doses will need to monitor eye health regularly to prevent retinal toxicity from long-term use.įor further information, consult these references: As a precaution, people treated with Plaquenil should get a baseline eye exam before (or soon after) starting the drug and visit an eye doctor (ophthalmologist) annually. In particular, hydroxychloroquine (Plaquenil®) can cause retinal toxicity over time, particularly at high dosages.Īnnual comprehensive eye examinations are recommended by the American Optometric Association for people with lupus, especially for anyone taking Plaquenil. In addition, some of the medications used in the treatment of lupus may have ocular side effects. Side-effects of certain lupus medications Damage to the visual nerve fibers in the brain may cause hallucination and loss of peripheral vision and/or central vision.Slow progressive vision loss also can result in more rapid loss of vision from lupus optic neuropathy. Lupus optic neuropathy occurs in one-two percent of people with lupus.Cranial nerve palsies can result in double vision, poor eye movement and alignment, poor pupil reflexes, and droopy eyelids.Neuro-ophthalmic involvement (nerve damage) There is an association between lupus choroidal disease and blood vessel disease in the rest of the body, which may be related to kidney disease and blood vessel disease complications seen in lupus. This involvement can appear as excess fluid between the retinal layers. The choroidal layer of the eye - the nourishing tissue underneath the retina - can also be affected by lupus, but this is very uncommon.Retinal vein occlusions (blockages) and retinal artery occlusions have been reported, but these complications are rare and seem to be more related with CNS lupus.For individuals with severe retinal vascular disease, the prognosis for vision is poor. Retinal blood vessel changes are due to lack of adequate blood supply to this delicate tissue, and may cause decreased vision ranging from mild to severe.The presence of these lesions seems to correlate with active disease.The lowest incidence reported is three percent, seen in outpatient clinics, and the highest is 28 percent in those hospitalized for lupus-related complications. The occurrence in lupus can vary depending on the population studied.This is the most common form of eye involvement in lupus. ![]() Retinal vascular lesions (blood vessel changes in the retina) Scleritis occurs in approximately one percent of people with lupus and may be the first sign of the disease.This painful red eye condition is caused by inflammation in the white scleral (outer) layer of the eye.The dry eye that is seen in lupus cannot be distinguished from other dry eye conditions.Advanced cases of dry eyes may result in damage to the front surface of the eye and impaired vision.Typical symptoms are irritated, gritty, scratchy, or burning eyes, a feeling of something in the eyes, excess watering, and blurred vision.(Primary Sjogren’s syndrome is a systemic disease that, like lupus, can affect many parts of the body.) Approximately 20 percent of people with lupus also have secondary Sjogren’s syndrome, a condition in which the tear glands do not produce sufficient tears to lubricate and nourish the eyes the other moisture-producing glands are similarly affected.Scarring may result in deformities along the edge of the eyelids.There are typically no symptoms, but occasional burning and itching may occur.The skin lesion is well-defined, slightly raised, scaly, and misformed (atrophic).This is most often related to the discoid lupus erythematosus form of cutaneous lupus.Involvement of the skin around the eyelids The effects lupus may have in and around the eyes include: changes in the skin around the eyelids, dry eyes, inflammation of the white outer layer of the eyeball, blood vessel changes in the retina, and damage to nerves controlling eye movement and affecting vision. The clinical course is unpredictable and is characterized by periods of remissions and flares, which may be acute or chronic. Lupus most often affects the heart, joints, skin, lungs, blood vessels, kidneys and central nervous system (CNS). Systemic lupus is a chronic autoimmune disease that can affect any part of the body, including the eyes.
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