Hydroxychloroquine, as coronavirus treatment, may be bad for your eyes
A drug that has stirred controversy as a treatment for coronavirus patients — and that President Trump said he is taking to ward off the virus — also has raised concerns about its effect on eyesight.
The drug, hydroxychloroquine, along with its older sibling chloroquine, has the potential to damage the retina. For this reason, eye care professionals recommend patients taking the drugs to treat lupus, rheumatoid arthritis or malaria get an annual eye exam.
What the AAO says about hydroxychloroquine
The American Academy of Ophthalmology (AAO) says hydroxychloroquine and chloroquine don’t cause blindness, but 1% to 2% of patients who take the drugs to treat autoimmune conditions such as lupus experience retinal problems during a five-year course of treatment.
The organization notes that patients with COVID-19, the sometimes fatal disease caused by coronavirus, who have been treated with hydroxychloroquine or chloroquine take double the usual dosage. COVID-19 patients, though, take the medication for only one to two weeks.
The AAO suggests that if you are over 50, have a history of retinal disease or macular degeneration, or have undergone tamoxifen therapy for breast cancer, you should consult your doctor before embarking on hydroxychloroquine or chloroquine treatment.
“You may be better off considering an alternate treatment,” the AAO says.
IF YOU SUSPECT YOU MAY HAVE CONTRACTED CORONAVIRUS... Contact your medical doctor to learn if and where you can get tested. If you have red eyes or conjunctivitis and think you may have coronavirus, call an eye doctor near you and schedule a telehealth virtual visit or in-office appointment.
Potential damage to the retina
Hydroxychloroquine and chloroquine can, in rare instances, cause retinopathy. Simply put, that’s damage to the retina, the part of the eye that senses light.
How much of these drugs someone takes each day and the length of time that someone has taken them are two of the key factors associated with this type of retinopathy.
Eye care professionals recommend an annual eye exam for people who take hydroxychloroquine or chloroquine, particularly those who are long-term users of the medication. A yearly screening can prevent the progression of retinal damage triggered by either of these drugs.
Symptoms of hydroxychloroquine or chloroquine retinopathy include difficulty reading, blurry vision, limited nighttime vision and loss of color vision.
Intended use of hydroxychloroquine
Aside from treating autoimmune diseases such as lupus and rheumatoid arthritis, the two drugs once were regularly prescribed to prevent and treat malaria. Malaria is a mosquito-borne, potentially fatal disease that’s common in Africa and Asia.
As the American Academy of Ophthalmology (AAO) and many other medical groups point out, there’s no scientific evidence that either hydroxychloroquine or chloroquine is effective in treating COVID-19.
The AAO says it “has no opinion on the use of chloroquine or hydroxychloroquine in COVID-19 patients.”
Limited evidence for successful treatment
A study published in April 2020 suggests that hydroxychloroquine, prescribed with or without the antibiotic azithromycin, decreases neither COVID-19 death rates nor the need for mechanical breathing help.
In fact, the study found hydroxychloroquine alone increases the risk of death. The study examined 368 men at Veterans Affairs hospitals in the U.S. who’d been treated for COVID-19 in March and April 2020.
These findings aren’t considered conclusive, though, since the study included a relatively small number of COVID-19 patients and was a limited observational review rather than a more trustworthy clinical review.
President Trump and hydroxychloroquine
President Trump said Monday that he has been taking hydroxychloroquine for about two weeks to prevent coronavirus infection. In recent weeks, some White House staff members have tested positive for the virus.
“I happen to be taking it,” Trump told reporters at the White House. “A lot of good things have come out. You’d be surprised at how many people are taking it, especially the front-line workers. Before you catch it. The front-line workers, many, many are taking it.”
President Trump has repeatedly touted hydroxychloroquine and chloroquine as promising treatments for COVID-19 and then later dramatically scaled back his praise — until Monday, when he announced that he is taking one hydroxychloroquine pill a day.
“I’m taking it, hydroxychloroquine," he said. "Couple of weeks ago, I started taking it. Cause I think it’s good, I’ve heard a lot of good stories.”
The president added that he also has been taking a daily zinc supplement and a single dose of azithromycin, an antibiotic meant to prevent infection.
White House physician Dr. Sean Conley, in a statement released after Trump's announcement, said that he and the president had "numerous discussions" regarding the evidence for and against the use of hydroxychloroquine.
"We concluded the potential benefit from treatment outweighed the relative risks," Conley said.
On Wednesday, after blowback from Trump announcing that he was taking hydroxychloroquine as a coronavirus preventative, the president said he would be ending his regimen in one or two days.
Cautions against use of hydroxychloroquine and chloroquine
The American Heart Association, American College of Cardiology and Heart Rhythm Society have urged caution in prescribing hydroxychloroquine and azithromycin for COVID-19 treatment. They cited “potential serious implications” for patients with cardiovascular disease.
Alluding to the potential heart problems, the U.S. Food and Drug Administration advises against administering hydroxychloroquine or chloroquine other than at hospitals or in clinical trials.
IF YOU ARE TAKING HYDROXYCHLOROQUINE OR CHLOROQUINE FOR CORONAVIRUS OR SOME OTHER CONDITION... Call an eye doctor near you and schedule regular eye exams.
Page published May 19, 2020