New Delhi: Today over 101 million adults (aged 20-79) in India are living with diabetes, a figure projected to reach 156.7 million by 2050, according to the International Diabetes Federation (IDF). While conversations around diabetes typically focus on blood sugar management, diet and medication, its impact on eye health often receives less than necessary attention.
One of the biggest challenges with diabetes-related eye disease is that it does not necessarily announce itself through changes in vision. Damage to the retina can develop gradually, often without noticeable symptoms. This makes regular eye examinations an important part of long-term diabetes management, rather than something to consider only when vision deteriorates.
Observed on November 14, World Diabetes Day emphasises the need of comprehending and treating diabetes-related issues beyond blood sugar control. Eye health, in particular, often gets overlooked, as diabetes-related eye conditions can develop without noticeable symptoms, making regular eye examinations and timely screening essential.
Prolonged high blood sugar can damage the tiny blood vessels supplying the retina, the light-sensitive tissue at the back of the eye. This condition, known as diabetic retinopathy, can weaken these vessels, causing them to leak fluid or blood. As the disease progresses, abnormal new blood vessels may develop, increasing the risk of bleeding, scar tissue formation and retinal detachment. If left untreated, diabetic retinopathy can lead to permanent vision impairment or blindness.
Another related complication is diabetic macular oedema (DME). The macula, located at the centre of the retina, is responsible for sharp, detailed vision. When damaged retinal blood vessels leak fluid into this region, it causes swelling that can affect central vision. Patients may experience difficulty reading, recognising faces or driving, activities that depend on clear and detailed vision.
Diabetes can also increase the risk of developing cataracts at a younger age and is associated with an increased risk of certain types of glaucoma, which can damage the optic nerve.
Risk increases with the duration of diabetes, poor blood sugar control and associated conditions such as hypertension and high cholesterol.
Clear vision and well-controlled blood sugar are often mistaken for signs that the eyes are healthy. While good blood sugar control reduces the risk of complications, it does not eliminate the possibility of retinal damage.
Nor are retinal complications confined to people who have lived with diabetes for many years. They can also be present in individuals who have recently been diagnosed, particularly when diabetes may have remained undetected for some time.
A 2025 study, based on diabetic retinopathy screening initiatives in rural Punjab, highlights some of the barriers to early detection. The researchers found that patients sometimes declined screening because they believed their eyes were healthy. Mobility limitations, distance from healthcare facilities and transportation difficulties also affected participation. While these findings relate to a specific rural population and cannot be generalised to all Indian patients, they illustrate why awareness of the asymptomatic nature of diabetic eye disease is critical.
Dr. Lalit Verma, Director, Retina Services, Centre for Sight and Former President, AIOS, emphasises the importance of routine screening in identifying retinal changes before they affect vision.
"Diabetic retinopathy is a major complication of diabetes, as retinal damage can progress even without noticeable visual symptoms. Regular retinal screening helps identify early vascular changes, examine the extent of retinal involvement, and understand the most suitable treatment plan. It's crucial to acknowledge that diabetes isn't only about managing blood sugar levels; timely eye checkups should also be promptly prioritized to keep away the risks of vision-threatening complications." (ANI)