Plaquenil (hydroxychloroquine) is an anti-inflammatory medication that is commonly used in cases of rheumatoid arthritis and lupus. It was originally (and still) used as an anti-malaria drug but has also been found to decrease inflammation in the body. While very effective, this medication can have ocular side effects. Prolonged use can lead to pigmentary changes in the retina and create central vision loss. The vision loss can be detected using a visual field testing machine that focuses on the central 10 degrees of your vision. Color vision seems to be affected first, so often this test is performed with a red filter. As damage occurs, the retina can develop a classic “bulls eye” appearance that can be seen on a dilated eye exam. Despite the potential risk, these visual problems are extremely rare and seem to present more with higher dosages of medicine taken for many years. The longer you are on Plaquenil, the more important regular eye checkups become.