Welcome to the forum Lainy
I am sorry for your predicament. I have never heard of anybody being taken off Plaquenil simply because they have been on it 20+ years. If there is no clinical reason, it's crazy considering all the side benefits Plaquenil brings as well as the very obvious ones like symptom relief.
It is true ( from all I have read) that dosage is cumulative so the risk of eye toxicity increases over time. I have variously read 6-10 years. But for heaven's sake if that is the main concern all that's needed is an eye test !
I presume that there are ophthalmologists even in Scotland:hehe: which would be the ideal, but I get my eyes tested for retinopathy by the optometrist at the SpecSavers on the High Street.
Perhaps there are not so many people on the forum who have been taking Plaquenil so long but overall the top doctors must be accurately informed when it has been used to treat lupus for so many years now and so much studied. Apparently there are other factors that can increase ocular toxicity - renal and liver complaints, and taking more than the maximum recommended dose that's been wrongly based on real body weight not ideal body weight.
One possibility is that he has some information that hasn't yet appeared in print. I must have been taking either Plaquenil or its stronger cousin chloroquine for at least 20 years including at least ten on maximum doses of the chloroquine which is generally reckoned to be a higher risk.
However, my doc at St Thomas' told me I needn't worry about eye tests ! I feel confident that if there was any risk he would have advised me to get them checked.
I now get an annual eye test free because I am over 65 but whatever anybody assures me, I would pay for it if need be, because it is too important to risk. I once mysteriously went deaf for a week, when I decided that my sight was overall the more important to me.
As I said maybe there aren't so many people who have taken Plaquenil 20+ years but I can say that apart from my own experience I have never heard of this, not in over ten years of reading forums and reading everything I can lay my hands on about lupus above all those aspects that directly concern me such as the anti malarials.
There is an alternative anti malarial called Mepacrine in the UK ( Quinacrine in the USA) that does not affect the eyes. It does much the same as Plaquenil often with the added advantage of being more energising. Plaquenil replaced it on the market for anti malarial prophylaxis so it is not readily available. The chemical has to be compounded: purified and made up into pills for human consumption. Many doctors are not aware that is is still available. I have to get mine from the hospital pharmacy on the consultant's prescription because my GP refuses to prescribe it as it is not licensed medicine. Some GP's will prescribe it on the consultant's recommendation and Boots will compound it.
It can be taken along with Plaquenil so you could gradually add one while reducing the other if need be. I dont understand why you shouldn't be started on another sort of medicine while you are reducing the Plaquenil What is the point of having you on nothing with all the suffering and poorer quality of life that will bring?
I don't like critizing doctors because there is often no choice or very difficult to make a change. Perhaps this information will empower you and you can have an informed discussion with him and get a better deal for yourself. Treatment these days should be a partnership. Maybe you can see another consultant in the same place for a second opinion if going to a different hospital is out of the question. Doctors in the same department can disagree. I hope you have a caring GP but suggest that anyway you let them know about your misgivings.
The mysositis is an obvious concern and one wonders what treatment plan he has for that. It shouldn't be left uninvestigated and unaddressed.
If you think you might be depressed you probably are so don't hesitate to seek help. It can be caused by lupus as well as reaction to the problems lupus brings. A suitable anti depressant can make all the difference between coping and not coping. Good luck with HR.
Lots of luck - please let us know how you get on
Clare