Hydroxychloroquine and Chloroquine

The CCGs are working towards establishing a service to monitor for hydroxychloroquine retinopathy. We have attached, for your information, a statement we are intending to include in a communication from DRSS to GP practices to update GPs on the current position. We understand that following the publication of the 2018 guideline from the Royal College of Ophthalmologists, high street optometrists are not in a position to monitor for hydroxychloroquine retinopathy. However, there will be patients receiving hydroxychloroquine who require a routine eye test for refraction, and who may need to purchase new glasses. We wish to reassure GPs that patients receiving hydroxychloroquine may continue to visit high street optometrists for this service. 

Monitoring for hydroxychloroquine retinopathy in Devon

The new Royal College of Ophthalmology (RCO) guidelines for hydroxychloroquine retinopathy represent a significant departure from previous guidelines and, as is the case with most parts of the country, require planning of services to accommodate into routine practice. The Devon CCGs are working through how to implement ophthalmological monitoring for patients receiving hydroxychloroquine with secondary care engagement. The subject has been discussed by the Devon Clinical Policy Committee at which the voting GPs recommended the principles by which a service should be commissioned. The details of how this will operate require working up. In the interim, the ophthalmologists consider that the risk to patients is low and whilst discussions are ongoing about establishing new local guidelines for monitoring patients, local ophthalmologists recommend that any patient with visual disturbance taking hydroxychloroquine should be referred to the eye clinic for review. Patients should continue to be advised to have normal, routine eye tests at high street opticians. Visual disturbance detected at such visits should also result in referral to the eye clinic.