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A 54-year-old African American female comes in complaining of blurry vision. The patient has a past medical history significant for gastroesophageal reflux disease (GERD), systemic lupus erythematosis (SLE) and chronic obstructive pulmonary disease (COPD) and a past ocular history significant for primary open angle glaucoma. The patient reports using hydroxychloroquine 400mg/day for the last 4 years.

1.	What is the earliest ocular side effect caused by hydroxychloroquine (Plaquenil)?
	a. ciliary muscle dysfunction b. corneal verticillata c. loss of the foveal light reflex d. fine granular depigmentation paracentrally in the macula e. none of the above
2.	Which factor puts this patient at high risk for retinal toxicity?
	a. age b. duration of treatment c. other systemic disorder(s) d. concurrent ocular disorder(s) e. none of the above
3.	The EARLIEST signs of retinal toxicity from hydroxychloroquine can be picked up by which of the following test(s)?
	a. Amsler grid b. visual field test c. full field electroretinogram (ERG) d. (a) and (b) only e. all of the above

For answers to the above, click here on or after November 17, 2009.