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The Royal College of Opthalmologists’ (RCOpth) publication, in February 2018, of new recommendations for screening of patients taking Hydroxychloroquine (HCQ) created significant challenges.

Around 320,000 patients currently take HCQ to manage long-term conditions such as rheumatoid arthritis. Taking HCQ for over five years causes increased risk of retinopathy, therefore it is now recommended that patients commencing long-term therapy receive baseline testing within the first year of treatment, followed by annual screening once patients have been taking HCQ for five years.

Eighteen months after the recommendations’ publication, practical and financial barriers to delivering this large-scale programme in the acute care setting have become clear.