Hydroxychloroquine is an anti-malarial and a Disease-Modifying Anti-Rheumatic Drug or DMARD. In Rheumatology, hydroxychloroquine is used most commonly for SLE, Rheumatoid Arthritis, and Sjogren's Syndrome. Because it may help prevent relapses, Hydroxychloroquine may be used for many years, if not decades. Evidence has shown the Hydroxychloroquine causes retinopathy, with the rate rising especially after 5 years. One in eighteen patients may expect significant retinopathy after 15 years of use, perhaps more with certain risk factors such as high dose or cumulative dose > 5000 grams, renal failure, and concurrent Tamoxifen use. As such, it is recommended to have a baseline eye exam before prescribing, followed by annual exams, especially after 5 years, using visual field testing and Spectral domain-OCT as performed by an Ophthalmologist.