Hydroxychloroquine (Plaquenil) screening

This condition is treated in the Ophthalmology (Eye) clinic.

Pre-referral work-up

History

Patients who have signs of retinopathy at screening or have equivocal findings should be referred promptly for specialist retinal assessment.

Patients requiring routine hydroxychloroquine (plaquenil) screening are not routinely seen at the Royal Hobart Hospital Eye Clinic. Routine screening should be performed by a local optometrist or ophthalmologist “see Guidelines for Screening for Hydroxychloroquine Retinopathy" (Royal Australian and New Zealand College of Ophthalmologists, 2021).

All referrals should comply with the outpatient information for clinicians page, Standard Referral guidelines and include in particular:

• Timing and pattern of vision changes
• Dose and duration of hydroxychloroquine
• Concomitant Tamoxifen or chloroquine use
• Concomitant retinal/macular disease
• Renal impairment

Tests

All non-emergency referrals need an ophthalmologist or optometrist report including:

• Best corrected reading and distance vision.
• dilated fundus examination,
• automated visual field testing and
• spectral-domain optical coherence tomography (SD-OCT)
• Extra tests, if available: fundus autofluorescence (FAF) and multifocal electroretinogram (mfERG)

Interim/GP management

To refer a patient with this condition, please see the Ophthalmology clinic page for the full referral process and templates.

Patients who have signs of retinopathy at screening or have equivocal findings should be referred promptly for specialist retinal assessment.

Diagnosis requires the comprehensive assessment of an ophthalmologist. Further confirmation may sometimes be required by a retinal specialist, especially in the cases requiring interpretation of electrophysiology. The diagnosis is then communicated to the patient, the treating doctor, and the general practitioner. The treating doctor then makes the decision to stop/alter the treatment regime as appropriate.

For more information please see the HealthPathways Tasmania website.

Clinic appointments

🚩 Red location flags are clinical indicators of possible serious underlying conditions requiring further medical intervention. They may or may not indicate an emergency.

Emergency

🚩Sudden loss of vision. Ring on call Ophthalmic Registrar to discuss.

If you, or someone else, are experiencing a serious and life-threatening injury or illness call triple zero (000) immediately or go to the nearest Emergency Department.

Learn more about when to access emergency care and non-emergency care options if the injury or illness is not serious or life-threatening.

Urgent (Category 1)

🚩Signs of retinopathy or equivocal findings at screening

Urgent referrals should be accompanied by a phone call to the Consultant/Registrar to organise urgent review and the referral must be faxed.

We will endeavour to see these patients within ten days, or sooner if clinically indicated.

Availability

North

THS Northern Region does not offer a public eye clinic. See Health Pathways for more information

North West

Unavailable.

South

Wellington Clinics (Level 11)
Phone: 03 6166 0000
Fax: 03 6234 9454