Pattern of Retinopathy: Although the locus of toxic damage is parafoveal in many eyes, Asian patients often show an extramacular pattern of damage. Dose: We recommend a maximum daily HCQ use of 5.0 mg/kg real weight, which correlates better with risk than ideal weight. Aps plaquenil Plaquenil and weight loss surgery Plaquenil and sun exposure The AAO published dosing and screening recommendations for chloroquine and hydroxychloroquine in 2016, revising previous recommendations published in 2011. The current maximum daily HCQ dose recommended by the AAO is 5 mg/kg of real weight. The 2011 guidelines suggested a maximum dose of 6.5 mg/kg of ideal weight. She suffered from Sjogren syndrome and inflammatory arthritis and was currently treated with prednisone and methotrexate. She was previously treated with hydroxychloroquine Plaquenil 200mg bid 6.5mg/kg for 10 years, which was stopped one year prior to presentation. Past Ocular History None Ultimately, the best place to learn about optometry billing is from your fellow optometrists. Many coding experts work across the healthcare industry, so their advice may not be tailored to optometry billing requirements. Even the most important book on the matter, the ICD-10, is a healthcare industry standard. Risk of Toxicity: The risk of toxicity is dependent on daily dose and duration of use. There are no similar demographic data for CQ, but dose comparisons in older literature suggest using 2.3 mg/kg real weight. Plaquenil standard of care optometry Quick Reference Screening for Chloroquine., Hydroxychloroquine Plaquenil Toxicity and Recommendations. Chloroquine show up on a drug testQ fever plaquenilHydroxychloroquine cause rash Although the incidence of macular toxicity is infrequent with Plaquenil use at a dosage of 200mg or 400mg q.d. its visual impact can be devastating. 2,3 The associated classic retinal toxicity is described as a bull’s eye maculopathy ring of depigmented retinal pigment epithelium that spares the foveal area. New Plaquenil Guidelines. The Ultimate Guide to Optometry Billing and Coding.. AAO Screening Guidelines for Plaquenil. Background The American Academy of Ophthalmology recommendations on screening for chloroquine CQ and hydroxychloroquine HCQ retinopathy are revised in light of new information about the prevalence of toxicity, risk factors, fundus distribution, and effectiveness of screening tools. But it was for alleged Plaquenil related eye toxicity, and believe me, attornies will grab any guideline they can as "Standard-of-Care" if it suits their case. All to say, we treat patients, not guidelines, but we all need to aware of these. The use of oral medications in optometry broadens our scope of practice and provides care that is more comprehensive for our patients. While topical medications treat a wide variety of ophthalmic disorders, we need to recognize when oral medications are a better option.