The prevalence of retinopathy among long-term users of hydroxychloroquine may be up to 15 times greater than many think, Australian clinicians say.

This significant underestimation of the permanent loss of vision associated with the anti-inflammatory drug has led to calls for the development of Australian-specific screening guidelines.

Once thought to be rare and affecting between 0.5-2% of long-term users of hydroxychloroquine, a more recent study found an overall retinopathy prevalence of 7.5% among patients taking it for at least five years.

The researchers — medical intern Marisse Sonido and dermatologist Dr Monisha Gupta, at Sydney’s Liverpool Hospital, along with ophthalmologist Dr Kristopher Rallah-Baker from the Sunshine Coast University Hospital — say an estimated 28,000 Australians use the drug daily for conditions including lupus and rheumatoid arthritis.