Plaquenil / hydroxychloroquine screening – Adult

Emergency and immediate referrals

Referral to Emergency:

  • Nil

Immediate referral:

  • Nil
Presenting symptoms
  • Patient on Plaquenil / Hydroxychloroquine
Mandatory referral information (referral will be returned if this information is not included)
  • Plaquenil dose and duration mg/kg of patient
  • Best corrected visual acuity (BCVA) - vision with most recent distance spectacles
  • Renal function and liver function
  • Details and duration of treatments 
Highly desirable referral information
  • Most recent optometrist or ophthalmologist reports/results if available and where providing it will not delay care including.
    • Colour vision
    • Optical coherence tomography (OCT) 
Indicative triage category
Indicative triage category
Cat 1
Appointment within 30 days
  • No category 1 criteria
Cat 2
Appointment within 90 days

High risk for retinal toxicity:

    • Duration > 5 years & dose of > 5 mg / kg
    • Or renal impairment
    • Or liver impairment       
Cat 3
Appointment within 365 days
  • On Plaquenil
Useful Information for referring practitioners

More information

Email: DOHSpecialistRAC@health.wa.gov.au