Private Hydroxychloroquine Eye Screening Cost UK

Private hydroxychloroquine eye screening costs from around £350 (indicative) in the UK in 2026 and includes the three tests recommended for detecting hydroxychloroquine retinopathy: a macular OCT scan, widefield fundus autofluorescence imaging and 10-2 visual field testing, reviewed by a consultant ophthalmologist. Screening is recommended annually once you have taken the drug for five years — earlier if you are on a higher dose, have kidney impairment or take tamoxifen.

Why hydroxychloroquine needs eye screening

Hydroxychloroquine is a safe and effective medicine for rheumatoid arthritis, lupus (SLE), Sjögren's syndrome and some skin conditions — hundreds of thousands of people in the UK take it. But in a minority of long-term users it slowly accumulates in the retinal pigment epithelium, the support layer beneath the retina, and damages the photoreceptors around the macula. This is hydroxychloroquine retinopathy.

Two things make it worth taking seriously. First, it is silent: by the time you notice difficulty reading or faint patches near your central vision, the damage is established. Second, it is irreversible — and can even progress for a time after the drug is stopped. The risk is low in the first five years but rises with duration and dose, which is why UK guidance is built around catching change early, before it can touch your sight.

Who needs screening — and when

Starting treatment: a baseline eye assessment within the first year of starting long-term hydroxychloroquine, so future scans have something to compare against.
From 5 years of use: annual screening for everyone still taking the drug.
Earlier annual screening if higher risk: dose above 5 mg/kg per day, kidney impairment, or concurrent tamoxifen — these substantially raise the risk and bring screening forward, usually to annually from the first year.

Not sure of your dose per kilogram? Bring your prescription — we calculate it as part of the assessment.

Five or more years on hydroxychloroquine and no recent retinal check? You are exactly who annual screening is for.

Book a screening

What the screening involves

History & dose review — how long you've taken hydroxychloroquine, your dose per kilogram, kidney function and other risk factors.
Macular OCT scan — a cross-sectional scan of the retinal layers that shows the earliest structural thinning of the photoreceptors. See our OCT retinal scan guide for how the technology works.
Fundus autofluorescence (FAF) — specialised imaging of the retinal pigment epithelium that highlights stressed cells before they die; often captured on the same ultra-widefield platform described in our Optomap scan guide.
10-2 visual field test — a fine-grained map of the central vision, the region hydroxychloroquine affects first. The same instrument is explained in our Humphrey visual field guide.
Consultant review & report — a consultant ophthalmologist interprets all three tests together and writes to you, your GP and your rheumatologist.

The visit takes around an hour. Dilating drops are usually used, so vision is blurry for a few hours afterwards — arrange transport home.

What it costs

Full screening assessment: from around £350 (indicative) — consultant review, OCT, fundus autofluorescence and 10-2 fields with written report.
Annual repeat screening: similar pricing; some patients alternate between NHS and private slots to stay on schedule.
Insurance: screening linked to a medically necessary drug is often covered — check with your insurer; we are recognised by Bupa, AXA, Aviva, Vitality, Cigna and WPA.

If a retinal problem unrelated to hydroxychloroquine is found, you'll get a clear explanation and fixed prices for any further care — see a typical retina specialist consultation for comparison, or our OCT angiography guide for the advanced macular imaging we can add where needed. All fees are listed on our prices page.

Your results and what happens next

Normal scans — you stay on your annual cycle, and each year's images are compared with your baseline. Possible early change — the tests are repeated or supplemented to confirm, because field tests in particular can produce false alarms. Confirmed early retinopathy — we report urgently to your prescribing team; the decision to adjust or stop hydroxychloroquine always sits with you and your rheumatologist, balancing eye risk against control of your underlying disease. Caught at this stage, most patients keep excellent central vision.

Frequently asked questions

How much does private hydroxychloroquine eye screening cost?+

From around £350 (indicative) for the full assessment — consultant review, OCT scan, fundus autofluorescence imaging and 10-2 visual field testing — with a written report copied to your rheumatologist or GP. Ask what any quote includes, as some clinics charge each scan separately.

Who needs hydroxychloroquine eye screening — and when?+

Royal College of Ophthalmologists guidance recommends a baseline assessment when starting long-term treatment, then annual screening once you have taken hydroxychloroquine for five years. Screening starts earlier — usually annually from one year — if you take more than 5 mg/kg per day, have kidney impairment, or also take tamoxifen.

Isn't this available on the NHS?+

Yes — NHS hydroxychloroquine retinopathy monitoring exists, but capacity varies by region and some patients wait a long time for their annual slot or are outside the local programme's criteria. Private screening is a same-week alternative that keeps you on schedule, with results shared with your NHS team.

Can screening find damage before I notice anything?+

Yes — that is the whole point. Hydroxychloroquine retinopathy develops silently, and by the time you notice reading difficulty or missing patches near the centre of vision the damage is established and irreversible. OCT and autofluorescence detect the earliest changes years before symptoms.

What happens if screening finds early changes?+

You do not simply stop the drug — for many people hydroxychloroquine is the medicine keeping their arthritis or lupus controlled. We report the findings to your prescribing rheumatologist or GP, who weighs the eye risk against your disease control and discusses alternatives. Never stop hydroxychloroquine without medical advice.

Private hydroxychloroquine eye screening cost UK