A major development in clinical practice has been new guidance from the Royal College of Ophthalmologists (RCOphth) on the risk of retinal toxicity from Hydroxychloroquine (HCQ) and Chloroquine [1]. The risk was previously considerably underestimated - the incidence is now felt to be up to 7.5% after 5 years’ use and 20–50% after 20 years’ use [1]. Much of the evidence for these estimates come from the US [2]. Early UK data is cited herein. Ophthalmologists are highlighting the need for greater awareness of these risks, and cases of missed retinopathy are appearing in the courts [3,4,5,6,7].

Having received a number of requests for advice on screening from NHS ophthalmology departments we provide our expertise from University Hospital Southampton (UHS), a major NHS university teaching hospital which has implemented the new RCOphth recommendations. UHS has about 1500 adults and 25 children on hydroxychloroquine.

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