High-risk category for early annual ophthalmology screening of patients receiving hydroxychloroquine

To the Editor: Although the recent article "Updated recommendations on the use of hydroxychloroquine in dermatologic practice" by Fernandez was overall both excellent and timely,1 I wish to offer a comment of clarification on the use of annual screening among hydroxychloroquine users. In the article, the author states, "Annual ocular toxicity screening is recommended to begin only after 5 years of use unless patients are considered high-risk or develop ophthalmologic symptoms." However, there are 2 caveats to this statement.