India is known as the “Diabetes capital of the world.” With over 101 million people living with diabetes in our country, this number is expected to reach 125 million by 2045. The constant rise in cases of diabetes is attributed to lifestyle modifications such as sedentary work, rising stress levels and comorbid conditions such as obesity and hypertension. Not only lifestyle changes but continuously changing environmental patterns such as increased pollution levels in cities, have also shown to be a key contributor to the condition. A healthy diet plays a crucial role in managing diabetes. Timely meals with a balanced diet are key to maintaining healthy sugar levels. An unhealthy lifestyle can lead to poor management of diabetes, which in turn leads to faster progression of diabetic retinopathy.

What Is Diabetic Retinopathy?

Diabetic retinopathy (DR) is an eye condition that can cause vision loss and blindness in people with diabetes. It affects blood vessels in the retina (the light-sensitive layer of tissue in the back of your eye).

Dr Manisha Agarwal, General Secretary, Vitreo Retinal Society of India, explains that diabetic retinopathy is common among the working-age population and impacts their physical and mental health. If not screened on time, this condition 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 (VTDR), approximately 3 million Indians are at risk of vision loss. This shows the critical need for timely screening for DR in every patient with diabetes to prevent an irreversible loss of vision, which goes undetected in its early stage and is thus known as a 'silent thief of sight.'

The Vitreo Retinal Society of India (VRSI) recently collaborated with the Research Society for the Study of Diabetes in India (RSSDI) to launch the national guidelines for diabetic retinopathy screening. According to the guidelines, the duration of diabetes is an important risk factor for the onset of diabetic retinopathy, and its progression is influenced by the status of metabolic control.

Diabetic retinopathy screening guidelines:

Type 1 Diabetes Mellitus:

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

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

- For women with diabetes and who are planning to conceive, it is crucial to assess their risk of developing diabetic retinopathy. Therefore, it is recommended that they undergo their first screening for diabetic retinopathy prior to conception. Further, it is advised for these women to have a follow-up screening during the first trimester of pregnancy to monitor any changes in their retinal health.

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

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

"In India, the growing number of people living with diabetes shows 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.

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