Are you going to be able to sleep is you take 30 mg in the afternoon? I have a terrible time sleeping on prednisone starting at about 10 mg.

2 questions both re medications:

Prednisone every day for how long???

***** [[ I read the following, this part is not me, you may wish to look it up to see if it helps you: thenazareneshul | @thenazareneshul | Sep 6, 2024 It was my Opthamologist who made me get off of Prednisone. It was literally blinding me. She saved my sight by doing all the tests (field of vision testing) that proved her right. Prednisone can cause glaucoma, which is very insidious as there often are no symptoms before your eyes get harmed. ]] ******

[[ my story about My brother he took Prednisone every day long term and it gave him a heart attack and his kidneys shut down, he passed away, he never bothered to change his doctor. ]]

MY STORY: My RA DR ONLY ALLOWS ME TO TAKE PREDNISONE VERY SHORT TERM IF ABSOLUTELY NECESSARY. I take methotrexate with my "hydro" for my RA.

I am taking Hydroxychloroquine [Brand and Other Names:Plaquenil, Sovuna] 200mg Tablets 2x a day? I know that causes a problem with your eyes because I am required to have my Ophthalmologist Not optomotrist check my eyes for damage 1x per year without fail. My ophthalmologist sends a report to my RA Dr and if I don't get MY yearly exam done my RA dr calls me and says get to your eye dr!!

*** I DID RESEARCH FOR MYSELF AND MAYBE SOME OF THE FOLLOWING INFO I FOUND MIGHT HELP SOMEONE ELSE .

Hydroxychloroquine retinopathy can be diagnosed through regular eye exams that include tests like optical coherence tomography (OCT), visual field testing, and fundus autofluorescence. There is no specific treatment for the damage caused, so early detection is crucial, and the best approach is to stop the medication if toxicity is found.

Eye Problems Associated with Hydroxychloroquine
Hydroxychloroquine can lead to several serious eye issues, primarily affecting the retina and cornea.
Retinal Toxicity
Symptoms: Early stages may show no symptoms. As toxicity progresses, patients may experience painless blurring of central vision, color vision changes, and blind spots.
Risk Factors: Higher daily doses (over 6.5 mg/kg), long-term use (more than 5 years), existing retinal disease, kidney or liver problems, and age over 60 increase the risk of retinal damage.
Prevalence: About 7.5% of patients develop retinal issues, which can rise to 20% after 20 years of treatment.
Detection: Regular eye exams are crucial. A baseline exam is recommended within the first few months of starting treatment, with follow-ups annually after five years if no other risks are present.
Corneal Effects
Keratopathy: Hydroxychloroquine can cause corneal verticillata, characterized by whorl-like deposits in the cornea. This condition is usually reversible upon stopping the medication and does not relate to dosage.
Monitoring and Management
Screening: Early detection through eye exams is essential, as damage can be irreversible if not caught early. If retinal damage is detected, discontinuing hydroxychloroquine is advised, and 1alternative medications may be considered.
Maintaining the recommended dosage and regular eye check-ups can help mitigate these risks.

@alandy233 Your vision problems are strange. I just googled your problems, and here is the AI answer, for what it is worth:

"Why would someone with GCA have vision problems after breakfast?

Someone with Giant Cell Arteritis (GCA) may experience vision problems after breakfast primarily due to jaw claudication, a common symptom where the muscles used for chewing become fatigued and painful due to reduced blood flow. In GCA, inflammation causes narrowing of the blood vessels, including those that supply the jaw and the eye, meaning the act of chewing can trigger ischemia (lack of blood flow) that extends to the optic nerve.

Key reasons for post-breakfast vision problems in GCA patients include:

Jaw Claudication-Induced Ischemia: The exertion of chewing breakfast can cause severe pain in the jaw, tongue, or throat. Because GCA affects arteries in the head, this same restriction in blood flow can cause temporary (transient) vision loss or blurring during or immediately after eating.
Amaurosis Fugax (Transient Vision Loss): Many GCA patients experience "amaurosis fugax"—a temporary, painless loss of vision in one eye, often described as a curtain coming down—before permanent, irreversible vision loss occurs. Chewing breakfast can be a specific trigger for these transient episodes due to the increased metabolic demand for blood in the facial muscles.

Reduced Blood Supply to the Eye: GCA leads to inflammatory narrowing of the ophthalmic artery or its branches, such as the posterior ciliary arteries. If these arteries are already compromised, the demand for blood flow during digestion or the physical act of chewing can cause a temporary drop in blood supply to the eye, resulting in blurry or double vision. "

So maybe there is a lack of blood flow to your eyes caused by these reasons.

You could try splitting your prednisone dose, but I wouldn't do an even split. It is more normal to do 75% - 25%. You could try 50 mg -10 mg or 45 mg - 15 mg.

Also, do you have access to a different doctor? It sounds like you need much better medical advice.

Check your blood pressure when
your vision diminishes it could be high or low even on prednisone.
Have you had a carotid ultrasound?

I have an issue totally unrelated to Prednisone and eyes. I just want to say this forum provided by Mayo is outstanding. It’s the reason I’ve followed the Mayo Clinic for years.