Hydroxychloroquine Ocular Toxicity: A Comprehensive Review.

Sit, Marisa; Mason, Ryan H; Kaplan, Alexander J · J Rheumatol · 2026

review · Level V

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Abstract

Hydroxychloroquine (HCQ) is a pharmacological agent in the management of various rheumatological disorders, including systemic lupus erythematosus and rheumatoid arthritis. Its therapeutic effects are attributed to its immunomodulatory and antimicrobial properties, and it is widely used due to its efficacy, relatively low cost, and generally favorable safety profile. Despite its well-established clinical utility, chronic use of HCQ is associated with serious ocular side effects. This review covers the history, pharmacokinetics, and ocular safety profile of HCQ, with a focus on the risk, diagnosis, and screening for ocular toxicity. Retinopathy, the most significant adverse ocular side effect, may lead to irreversible vision loss if not promptly detected.

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