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According to a study conducted by the Indian Council of Medical Research (ICMR) and published in The Lancet, India’s diabetes crisis has reached alarming proportions: over 100 million Indians now live with diabetes – a staggering 43% increase from 70 million cases in 2019. Even more concerning, an additional 136 million people are classified as pre-diabetic, putting nearly a quarter of the population at risk
The disease impacts every organ—including the eyes- often with devastating consequences. To explore this pressing public health challenge, Firstpost spoke with leading retina specialists Dr. Daraius Shroff (Director) and Dr. Gagan Bhatia, a renowned retina surgeon from Shroff Eye Centre. They shed light on the critical aspects of diabetic retinopathy and its far-reaching implications.
India’s diabetes numbers are staggering — what does that mean for vision?
The statistics paint a troubling picture. Recent studies reveal that just 7% of Indians maintain properly controlled blood sugar levels. The majority remain unaware of their diabetic status or have never undergone glucose testing. This unchecked epidemic is driving a sharp rise in diabetic retinopathy cases – where prolonged high blood sugar progressively damages retinal blood vessels, potentially leading to permanent vision loss.
What eye problems do diabetics face?
Dr. Gagan Bhatia: Uncontrolled diabetes wreaks havoc on eye health with high blood sugar causing multiple vision-threatening complications. The most common issues include frequent changes in eye power, premature cataracts and diabetic retinopathy. Over time, diabetes weakens retinal blood vessels, leading to progressive damage: fluid leakage causes retinal swelling and cholesterol deposits and severe cases can lead to a bleeding in the eye. These changes often develop silently but can ultimately result in irreversible vision loss.
How frequently should diabetic patients undergo eye examinations?
Dr. Daraius Shroff: Early detection saves vision. All diabetics should undergo annual dilated eye exams—ideally starting immediately after diagnosis to establish a retinal baseline. Studies reveal that 4-7% of newly diagnosed diabetics in India already show signs of diabetic retinopathy.
For high-risk individuals—such as those with existing retinopathy or uncontrolled blood sugar—more frequent screenings are essential. Advanced retinal imaging and comprehensive exams play a critical role in timely intervention. Remember: Even without symptoms, annual retina checkups are non-negotiable for every diabetic.
What are the key risk factors for diabetic retinopathy in India?
Dr. Gagan Bhatia: Indians are predisposed to developing diabetes. In urban areas, our carbohydrate-rich diets and lower levels of exercise are increasing the problem of uncontrolled blood sugars. Several factors contribute to the development and worsening of diabetic retinopathy -Poor blood sugar control, long duration of diabetes, high blood pressure, high cholesterol, smoking, obesity and lack of awareness about the disease and its complications.
What treatment options are available for diabetic retinopathy?
Dr. Daraius Shroff: The treatment of diabetes depends on the stage of diabetes and includes laser photocoagulation, intravitreal anti-VEGF injections, and vitrectomy surgery. Anti-VEGF injections are the biggest blessing for diabetics as they help to reduce swelling in the finer vision area of the retina and preserve vision. Laser treatment is done in cases with abnormal blood vessels in stage of proliferative retinopathy to promote their regression and stabilize the disease.
Many people feel that laser is harmful and don’t get it done, but over many years, it’s a proven and most important in such cases and helps in the prevention of bleeding in the retina.
Vitrectomy is performed in severe cases to remove blood and membranes and also burn all the abnormal blood vessels to prevent recurrent bleeds and also settle the retina if the retina detaches in extreme cases of diabetic retinopathy.
What advice would you give to individuals with diabetes to protect their vision?
Dr. Gagan Bhatia: The cornerstone of prevention is strict blood sugar control—whether through oral medications or insulin therapy as prescribed by your endocrinologist.
Modern monitoring tools now enable regular glucose tracking, making management more precise than ever.
Pair this medical treatment with:
• A nutritionist-approved balanced diet
• Consistent physical activity
• Overall healthy lifestyle habits
Importantly, patients must recognise diabetic retinopathy’s warning signs (like sudden vision changes) and seek immediate care. No matter how well-controlled your diabetes seems, annual comprehensive eye exams remain very crucial for preserving vision.
How do patients know when diabetes starts impacting their vision?
Dr. Gagan Bhatia: Most patients with uncontrolled sugars may experience fluctuating eye power, blurry vision, an increase in floaters, dark spots in the visual field or vision loss. Even with no symptoms, diabetics must get annual eye checkups.
How does diabetes impact our healthcare system?
Dr.Gagan Bhatia: The burden is staggering. Treating diabetic retinopathy—with its demanding regimen of laser therapies, injections and surgeries—already strains healthcare systems. Yet this pales against the colossal challenge of managing diabetes itself. Vision loss compounds the crisis, triggering job losses, slashed productivity, and increased dependency—devastating both lives and our economy.
The situation worsens beyond urban centers: inadequate rural infrastructure and widespread lack of awareness have made this the fastest-growing cause of preventable blindness.
Studies warn of a gathering storm—India’s diabetes-related economic costs are projected to surge dramatically in coming decades, with retinopathy playing a central role in this unfolding disaster.”
What public health strategies are needed to better manage diabetic retinopathy in India?
Dr. Daraius Shroff: We need to prioritize diabetic retinopathy – along with diabetes- as a public health issue. Proper guidance and eliminating stigma and misinformation associated with diabetes treatment is important. Early detection, timely treatment, and comprehensive management are crucial to prevent avoidable blindness.
A multi-pronged approach is essential. First, we need to improve diabetes prevention and management through public awareness campaigns and access to affordable healthcare. Second, nationwide screening programs for diabetic retinopathy are vital for early detection. This area has seen some strides- with AI models being developed by many (including Google)- to screen retina fundus images for diabetes.
Third, we need to train more people to screen retina as well as train more retina specialists as there are very very few retina specialists. Research and development of new treatments and technologies are ongoing, and these are necessary to combat this growing problem.