Eye exam before starting Plaquenil

Is it important that we see an opthamologist before starting plaquenil or is it ok to see an optometrist? I have called several places, but most don't just do eye exams...they only see patients who have specific problems. I know many optometrists now use the eye dialating techniques and even have some of the same equipment as opthamologists. Which did you see before starting Plaquenil and what kind of test do they need to run? Just an eye exam or do they need to dialate the eyes to look further at the retina?

Do they understand you aren't asking for "just an eye exam," but for a baseline before plaquenil? Maybe your hema or rheumatologist could make a referral? Julianne's hema is at a medical college hospital, so we have a pretty easy time getting referrals to other specialists within that organization. If you can get to one, Smother Mother here certainly votes for ophthalmologist over optometrist. Good luck.
Norma

Pauline - you need to ask when you call if they do a "Plaquenil check". If they don't know what you're talking about, they probably don't do it. I see an ophthalmologist, not an optometrist. They do special tests - one is the visual field test that requires a special machine.

I'd say it's pretty important to have that done before starting Plaquenil. They need a baseline. Plaquenil can cause all sorts of serious eye problems...they are rare, but they do happen.

After calling quite a few pediatric opthamologists and finding out the earliest available appointment was Sept/Oct, I finally decided to call my own opthamologist, who is a retinal specialist. At first, they wanted to know why I would bring them there for an eye exam and when I mentioned Plaquenil, they said they'd take her in and they will see her Friday afternoon! She's done 3 of my surgeries so I feel like I know how thorough she is. I just hope she has seen children before because the waiting room is usually filled with an older population which is understandable since that is when most retinal problems appear.

I think it's great that they knew what it was and got her in so fast! She's 12, right? I wouldn't worry about the pediatric part so much, as long as she knows what she's doing. They should also check for color-blindness at every exam. They will dilate her eyes, so I hope she doesn't have any major plans after.

I hope they will know what to do too! Yes, she is 12, but she looks more like she is 8 or 9 due to her height and weight. I hope the exam goes well and I figured they'd have to dialate her eyes, yuck! I hope family history doesn't get taken into account because my father-in-law is color-blind (and sometimes I think my husband is) and then I've had numerous retinal problems over the years. My retinal specialist actually got on the phone and asked if I had Lupus too...makes me wonder if I should be asking for a panel because the one thing I do have going on is multiple organ involvement problems and even the joint pain. (eyes, kidneys, pancreas) One thing at a time though! My medical insurance and my wallet really can't handle too much more!

Optometrists can do the plaquenil check if they have the machine to do the field of vision test. I have had mine done by both types of doctors.
Erica

I think my optometrist also has all the machines to do the testing. Took her to an opthamologist yesterday. I don't know if they did everything they were supposed to do since I don't really know what tests are what. If the field vision test is the grid with a cross in the middle, they did that. Don't know about a color test though. They seemed to do a normal vision exam and then they looked into each eye to check the retina to make sure there were no abnormalities. The dr said everything looks good and will send a letter to both her hematologist and rheumatologist. Once they receive that, Caitlin will start the Plaquenil. Her opthamologist said that it is really rare for Plaquenil to cause vision problems and the only patients (she's had 2) that had some problems were patients that had a substantial weight loss so the dosage was too high, therefore resulting in Plaquenil toxicity.

The visual field test is where you look into a machine with one eye and it's black inside with flashing lights. You press a button every time the light flashes, and it measures whether you have peripheral vision and middle vision. It's very boring and I have a hard time keeping my mind on it....I start day dreaming.

Hi Pauline!

Glad you enjoyed your Florida vacation and scalloping! My Caitlin is WAY into scuba diving, and I'm sure I don't hear about all the sharks and other bite-y things she sees down there!

At least one test for color-blindness asks the patient to tell the examiner what number is seen in a field of bubbles. The number is 'written' in a series of linked bubbles, against a background of other-colored bubbles--people with color-blindness can't see the difference between the 'background' and the number. I think I went looking for this type of test online awhile ago--and found it!

Good luck to you and your upside-down girl! Ann, Caitlin's (23) Mom

I've done that too...gone online to test my color vision. Sometimes my ophthalmologist forgets.