Eye Appointments, Plaquenil, and RA

There's an unusual interloper in my healthcare team that is surprisingly related to me having rheumatoid arthritis (RA): an ophthalmologist and optometrist.

This might seem like a weird connection, but eye health and having RA are actually very much related.

Why I take care of my eye health

Even though RA can affect the eyes in a lot of ways (dry eyes, general inflammation, etc.), the major way that RA can affect the eyes is if you're on Plaquenil to help manage your symptoms.

I've been on Plaquenil since I was first diagnosed with RA in October 2018.

Bullseye ring around the retina

Every 6 months (at a minimum), I've had to go to the optometrist to make sure that a bullseye ring was not forming around my retina, which would indicate that my retina is becoming toxic and/or detaching.

This is a side effect of taking Plaquenil, a medication that is commonly used to treat lupus. This is actually why I started taking this medication - both my lupus markers and inflammation markers were elevated.

Measure inflammation and pressure

While this constitutes the main reason why I have to go to the eye doctor because of RA, I do know that it's beneficial for me to go to the eye doctor often to measure inflammation and pressure on my eyes, too.

It also helps to see (with updated prescriptions), as well!

Eye exams due to Plaquenil treatment

Measuring my eye and retina health due to the use of Plaquenil involves taking multiple scans of my retina in a separate machine from other scans and measurements.

This involves pushing your eye up to a concave inset and waiting until a green light flashes (which measures both your eye pressure and your retinas). It's a really fascinating machine and provides a lot of helpful information.

Retina scans not covered by my insurance

I'm not sure if this is the same for everyone, but these scans, while necessary for my eye health, are often not covered by eye insurance (or health insurance for that matter).

This is frustrating because I need to be on Plaquenil (which has this known side effect of damaging retinas). Yet, I can't get the scans covered by that same insurance.

At least the cost isn't too burdensome

Why is it that insurance would cover one aspect of my health but not the other, even when they are intricately related and, honestly, are part of the same problem/medical necessity?

If there is a bright side to this situation, the only bright side, thankfully, is that the scans are only 25 dollars out-of-pocket. I still shouldn't have to pay for them, but at least it isn't too burdensome.

Eye health is part of RA care

Going to the eye doctor is also unique because they aren't first on the list of healthcare professionals that work in concert with rheumatologists, primary care physicians, and others.

My eye doctors and rheumatologist work together

It's interesting having conversations with my eye doctors and rheumatologists in having them work together because they're two offices that I never thought would have to work together, to begin with.

However, I've never had a problem getting my rheumatologist and eye doctor to work with each other.

Grateful for informed doctors

This probably seems axiomatic but thankfully my rheumatologist was aware that I would have to go to the eye doctor when starting Plaquenil because otherwise, I wouldn't have known.

I'm also thankful that my eye doctors actually know about Plaquenil's side effects when treating RA — which I can't really say the same for other doctors that I have had in my long medical history.