Key PointsQuestionWhat are the screening practices for hydroxychloroquine retinopathy in South Korea?FindingsThis nationwide population-based cohort study of 65 406 patients at risk of retinopathy (29 776 long-term users of hydroxychloroquine) using national health insurance claims data found that the annual number of hydroxychloroquine users increased from 2009 to 2020; baseline screening was performed for 20.8% of the patients within 1 year, with a gradual increase from 16.6% in 2015 to 25.6% in 2021. Annual percentages of patients receiving appropriate screening for retinopathy showed an improving trend for both baseline and monitoring examinations; those who underwent baseline screening received monitoring examinations more frequently than those who did not.MeaningThis study suggests that most long-term hydroxychloroquine users in South Korea have not undergone screening for retinopathy after 5 years of use; however, baseline screening may be useful in reducing the number of unscreened long-term users.