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With over 101 million people with diabetes in India, the country has emerged as the diabetes capital of the world. As a result, a simultaneous and sharp rise has been observed in the prevalence of diabetes-related preventable vision loss. A diabetologist plays an important role in timely screening for diabetic retinopathy and referring to an ophthalmologist for its management. Vitreo Retinal Society of India (VRSI) and the Research Society for the Study of Diabetes in India (RSSDI) recently collaborated and launched first-of-its-kind Diabetic Retinopathy Screening Guidelines, which will help every physician and diabetologist in India to educate their patients regarding diabetic retinopathy.

Owing to lifestyle modifications, migration to cities, obesity, and stress, there has been an increase in the number of diabetes patients in the country, parallelly increasing the number of diabetes-related vision loss cases. Type -2 diabetes is common amongst the working-age population, impacting their physical and mental health. This condition, if not screened timely, can become the leading cause of blindness in India, causing a huge economic burden. With a national prevalence of 12.5 per cent of diabetic retinopathy and 4 per cent of vision-threatening ‘Diabetic Retinopathy’, approximately 3 million Indians are at risk of vision loss. This shows the critical need for timely screening of every patient with diabetes to prevent an irreversible loss of vision, which goes undetected in its early stage and is thus aptly known as a 'silent thief of sight.'

This initiative aims to empower healthcare professionals—often the first point of contact for those living with diabetes—with the tools and knowledge necessary to promote early detection and intervention, ultimately reducing the risk of severe vision impairment and blindness caused due to diabetic retinopathy.

Diabetic Retinopathy Screening Guidelines For Physicians In India:

Type 1 Diabetes Mellitus:

Initial eye examination recommended 5 years following diagnosis of type 1 diabetes mellitus.

Type 2 Diabetes Mellitus:

An initial eye examination is recommended at the time of diagnosis of type 2 diabetes mellitus.

Pregnancy In Patients With Diabetes Mellitus:

- Eye examination prior to conception and early during 1st trimester.

- Follow-up should be individualized based on severity and recent changes in retinopathy.

Diabetic Retinopathy Severity:- No Apparent DR: Annual fundus photo screening at Physician clinic.

- Any evidence of DR or DME: Immediate referral to an ophthalmologist.

Dr Sudha Chandrashekar, Former Executive Director, National Health Authority – Ministry of Health and Family Welfare, added, “To safeguard the vision of millions of Indians living with diabetes, diabetic retinopathy screening has been integrated into the government’s Ayushman Bharat scheme. By prioritizing early detection at a national level, this initiative aims to preserve eyesight and improve health outcomes across the country. Diabetic retinopathy screening is particularly beneficial for the beneficiaries of the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana (AB-PMJAY) scheme, helping to avoid higher costs in the management of advanced stages of DR and ensuring better health outcomes.”

Dr R Kim, President, VRSI, commented, “We’re pleased to collectively unveil these guidelines and set a new standard for diabetic retinopathy screening in India. By encouraging collaboration between physicians, diabetologists, and ophthalmologists, we aim to promote better diabetes management and reduce the incidence of preventable vision loss across the nation.”

Highlighting the importance of diabetic retinopathy screening, Dr Manisha Agarwal, Gen Secretary, VRSI, said, "Despite the increasing prevalence of diabetic retinopathy, limited awareness and the often asymptomatic nature of the condition result in a disappointingly low number of individuals with diabetes seeking eye screenings. This makes it imperative to raise awareness about vision loss due to diabetic retinopathy and the need for timely screening and management.”

"In India, the growing number of individuals living with diabetes highlights the importance of not only monitoring glucose levels but also undergoing regular screenings for other health complications associated with diabetes to maintain overall health. Diabetic retinopathy is one such complication that, if left untreated, can cause severe and often irreversible vision loss. These guidelines will play a key role in increasing awareness among general physicians and diabetologists about the critical need for timely diabetic retinopathy screening," stated Dr Sanjay Agarwal, Secretary General, RSSDI.

Published in the renowned International Journal of Diabetes in Developing Countries, the guidelines mark a crucial milestone in India’s journey to advancing diabetes management and screening for Diabetic retinopathy effectively.

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