What You Should Know About Retinal Health and Long-Term Medication Use
Originally published by Retinal Consultants Medical Group
Certain medications play a crucial role in managing chronic conditions, but some can have side effects that affect your eyes, especially the retina. If you take drugs like hydroxychloroquine (Plaquenil) or corticosteroids, it’s important to be aware of how they may impact your vision and why regular eye exams are key to protecting your sight.
Medications That Can Affect the Retina
Hydroxychloroquine (HCQ):
Often prescribed for autoimmune conditions like lupus and rheumatoid arthritis, HCQ is highly effective in controlling inflammation. However, long-term use has been associated with retinal toxicity, which can cause irreversible damage to the retina and lead to vision loss. Though relatively uncommon in the short term, the risk increases with prolonged use – up to 20% of patients may develop retinal complications after two decades on the medication.
Corticosteroids:
Steroids are used to treat a wide range of inflammatory, immune-related, and oncologic conditions. However, extended use may lead to eye issues such as:
- Central serous chorioretinopathy (CSC) target true: Fluid builds up under the retina, which may distort or blur vision.
- Cataracts: Clouding of the lens that can cause blurry vision and increased sensitivity to light.
- Glaucoma: Increased pressure in the eye that can gradually damage the optic nerve and lead to vision loss if untreated.
Who’s Most at Risk?
Not everyone who takes these medications will experience eye complications, but certain factors can increase your susceptibility.
For HCQ users, risk factors include:
- Taking a daily dose higher than 6.5 mg per kg of body weight
- Prolonged use (typically beyond 5 years)
- Older age (over 60)
- Pre-existing kidney or liver issues
- Existing retinal disease
- Obesity
HCQ toxicity usually develops without any noticeable symptoms. Most patients don’t realize there’s a problem until the central part of the retina (called the macula) is affected, impacting detailed vision tasks like reading or recognizing faces. When symptoms do appear, they may include painless, progressive blurring of central vision.
For steroid users, the elevated risk applies to people who:
- Have diabetes
- Have a personal or family history of glaucoma
- Are very nearsighted
- Have rheumatoid arthritis
- Are older adults or children under six
Steroid-related eye effects can appear within weeks and may cause increased eye pressure, leading to glaucoma or vision changes. Cataract symptoms might include faded colors, double vision, halos around lights, and trouble seeing at night. CSC may cause straight lines to appear wavy or distorted, and objects might seem smaller or more distant in the affected eye.
Why Regular Retina Exams Matter
The key to protecting your sight is early detection. In the case of HCQ-induced retinal damage, there is no treatment that can reverse the effects, so catching changes early, before symptoms begin, is essential. For patients taking steroids, many eye conditions can go unnoticed until they’re more advanced and harder to manage.
If you’re using these medications long-term, routine retinal eye exams should be part of your ongoing care. Advanced imaging tools can help detect subtle changes in the retina before you experience vision loss.
Partnering With a Retina Specialist
At Retinal Consultants Medical Group, we work closely with your primary care and prescribing physicians to monitor your eye health and reduce risks. If you’re taking medications known to affect the eyes, we recommend annual or semiannual dilated eye exams and specialized retinal screenings tailored to your medical history. Protect your vision and schedule your screening today.