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Risk? All doctors I have seen have never been overly concerned as they say the risk is very low and many of them say they have seen no cases or very few. My dose is 200 mg daily and I weigh around 121 lbs. I got along so much better at 400 mg daily.

May 12
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Answer Summary

Members discussed the eye risks of long-term hydroxychloroquine use, with many sharing that after 10 to 32 years on the medication, regular... Read more

Members discussed the eye risks of long-term hydroxychloroquine use, with many sharing that after 10 to 32 years on the medication, regular eye exams showed no damage. Several members highlighted the importance of following the recommended dose of no more than 5 mg per kg of body weight to protect eye health, and stressed that faithful yearly ophthalmology visits are key. A deeply moving theme emerged when one member shared a heartbreaking experience of vision loss from being overdosed relative to her weight, reminding the community how critical proper dosing and early monitoring truly are.

A MyLupusTeam Member

Been taking 400 mg Hydroxy for approximately 14 years. I get yearly eye exams. So far, no problems and still have 20/20 eyesight.

May 12
A MyLupusTeam Member

A maximum of 5 mg/kg of body weight is the recommended dose to prevent eye toxicity, so one must weigh at least 176 lbs to take 400 a day, and at least 132 lbs to take 300 mg daily. The risk is very low if this dosing is followed.

I took it for 32 years and stopped due to arrhythmias. Though it's not officially recommended, it's reasonable to ask your doctors to check an annual EKG if you're on HCQ.

May 13
A MyLupusTeam Member

I have been taking 200 mg of Hydroxychloroquine once a day for about 15 yr now. I weight 100 lbs. No side effects so far, and I do go to my Ophthalmologist faithfully for all these years. My Rheumatologist won't prescribe unless I do!

May 12
MyLupusTeam

That's a great question, and it's clear you've been managing lupus thoughtfully for a long time — 25 years on hydroxychloroquine is significant!

The risk of retinopathy (eye damage) from hydroxychloroquine is generally low, especially at lower doses. Research suggests the risk remains under 2% within the first 10 years of Show Full Answer

That's a great question, and it's clear you've been managing lupus thoughtfully for a long time — 25 years on hydroxychloroquine is significant!

The risk of retinopathy (eye damage) from hydroxychloroquine is generally low, especially at lower doses. Research suggests the risk remains under 2% within the first 10 years of use, but can rise to around 20% after 20 years of use. So at 25 years, the risk does become more meaningful over time, even if individual doctors haven't seen many cases personally. At 200mg daily and 121 lbs, your dose is actually on the lower end, which is a protective factor. The higher-risk profile includes people who:

- Take more than 400mg daily
- Have used it for longer than 5 years
- Are over 60
- Have reduced kidney function
- Have a history of retinal disease

Given your 25-year history, regular eye monitoring is really important, regardless of how low the risk feels day-to-day. The American Academy of Ophthalmology recommends annual comprehensive eye exams after 5 years of use. Ideally, seeing a retinal specialist (not just a general eye doctor) gives the most thorough monitoring.

Regarding the 400mg dose feeling more effective — that's worth an honest conversation with your rheumatologist. They can weigh the benefits against the eye risk at your specific weight and health profile. It's absolutely a valid discussion to have!

May 12
A MyLupusTeam Member

@Douginnc--Are you taking anything else? If so, it won't be AS difficult. It takes a long time for HCQ to wash out of your system, so you may not feel the effects of stopping it for a couple of months.

Please talk to your doctor first! It may be safer to discuss reducing the dose to see how you do.

May 14

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York, NE