Hydroxychloroquine (Plaquenil) screening

The Department will periodically contact patients waiting for an outpatient clinic appointment via SMS, with a link to an electronic form.  This is part of routine waitlist auditing to ensure patient details are up to date.  If you receive this SMS, please update your details.

Availability

North South North West Statewide

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 RHH 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 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 Tasmanian Health Pathways website.

Emergency

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

Urgent / category 1

Signs of retinopathy or equivocal findings at screening

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

Emergency:

Proceed to Emergency Department (ED).
LGH ED Reception  – Phone: (03) 6777 6405  Fax: (03) 6777 5201
MCH ED* – Phone: (03) 6478 5120  Fax: (03) 6441 5923
NWRH ED* – Phone: (03) 6493 6351 Fax: (03) 6464 1926
RHH ED Reception – Phone: (03) 6166 6100  Fax: (03) 6173 0489

Advice for medical practitioners can be given by the Medical Officer In Charge (MOIC) - see HealthPathways Tasmania for contact information.
*MCH and NWRH MOICs request GPs call them prior to referring a patient to ensure the patient is being sent appropriately to a safe destination.

Urgent:

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.

Semi-urgent:

We will endeavour to see these patients within 12 weeks

Routine:

Next available appointment