World Diabetes Day 2026: Not just blood sugar, why eye checkups should also be a priority

Diabetes management usually revolves around blood sugar levels, medication, diet and exercise. But there is another aspect of the condition that deserves equal attention: eye health. A person living with diabetes may have perfectly clear vision and still be developing damage to the retina. This is what makes diabetes-related eye complications particularly concerning. Unlike several other health problems, retinal damage may not produce noticeable symptoms during its early stages. By the time blurred vision or other difficulties become apparent, the condition could have already progressed.

Observed every year on November 14, World Diabetes Day serves as a reminder that managing diabetes requires more than monitoring glucose levels. Regular eye examinations, particularly retinal screening, should become an essential part of healthcare for people living with the condition. According to the International Diabetes Federation (IDF), more than 101 million adults aged 20-79 are living with diabetes in India. This number is projected to reach 156.7 million by 2050, highlighting the growing importance of identifying and managing diabetes-related complications.

How diabetes silently affects your eyes


Prolonged high blood sugar levels can damage the tiny blood vessels that supply the retina. The retina is the light-sensitive tissue at the back of the eye that helps process visual information. This damage can lead to diabetic retinopathy, one of the most serious eye complications associated with diabetes. Initially, weakened blood vessels may leak blood or fluid into the retina. As the condition advances, abnormal blood vessels can develop, increasing the risk of bleeding, scar tissue formation and retinal detachment.

Without timely diagnosis and treatment, diabetic retinopathy can cause permanent vision impairment and, in severe cases, blindness.

Another complication is diabetic macular oedema (DME). The macula is the central part of the retina responsible for detailed vision. When damaged blood vessels leak fluid into this region, swelling develops and affects the ability to see clearly.

People with this condition may struggle with everyday activities such as reading, recognising faces or driving. The difficulty can gradually interfere with their independence and quality of life.

Diabetes can also increase the chances of developing cataracts at a younger age. It is also associated with a higher risk of certain types of glaucoma, which can damage the optic nerve and affect vision. The risk of these complications generally increases with the duration of diabetes. Poor blood sugar control, high blood pressure and elevated cholesterol can further increase the chances of eye damage.

Why normal vision does not mean healthy eyes

One of the biggest misconceptions about diabetic eye disease is that people associate healthy eyesight with the absence of complications. However, diabetic retinopathy can progress without affecting vision initially. A person may continue reading, working on a computer and performing everyday activities without realising that retinal damage has begun.

This often creates a false sense of security. Some patients postpone eye examinations because they do not experience discomfort or notice any change in their eyesight.

The problem is not restricted to people who have lived with diabetes for decades. Retinal complications can also be detected in people recently diagnosed with Type 2 diabetes, particularly when the condition may have remained undetected for several years.

Dr. Lalit Verma, Director, Retina Services, Centre For Sight and Former President, AIOS, highlights why routine retinal examinations should not depend on the appearance of symptoms. "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," he says.

He further emphasises that people should recognise the connection between diabetes management and eye health.

"It's crucial to acknowledge that diabetes isn't only about managing blood sugar levels; timely eye checkups should also be promptly prioritised to keep away the risks of vision-threatening complications," Dr Verma adds.

These changes in vision should not be ignored

Although early-stage diabetic retinopathy may not cause noticeable symptoms, certain changes can indicate that the eyes need immediate medical attention.

People living with diabetes should watch out for:

• Blurred or gradually deteriorating vision.
• Difficulty reading or recognising familiar faces.
• Fluctuating eyesight, with vision becoming clearer or blurrier at different times.
• Dark spots or floating shapes in the field of vision.
• Distorted vision or difficulty focusing on objects.
• Flashes of light or a sudden increase in floaters.
• A dark, curtain-like shadow covering part of the visual field.

Sudden flashes, a rapid increase in floaters or a curtain-like shadow can indicate a serious retinal problem. Such symptoms require urgent examination by an eye specialist. However, the absence of these warning signs should never become a reason to skip routine screening. Waiting for vision to deteriorate can mean losing valuable time for early intervention.

When should people with diabetes get their eyes checked?

Regular comprehensive eye examinations are an important part of diabetes care. The timing of the first examination depends on the type of diabetes and the patient's medical history. According to Indian consensus guidelines developed by the All India Ophthalmological Society (AIOS) and Vitreo-Retinal Society of India (VRSI):

Type 1 diabetes: Patients should undergo their first comprehensive dilated eye examination within five years of diagnosis, followed by regular annual screening.

Type 2 diabetes: Patients should undergo a comprehensive eye examination at the time of diagnosis itself, followed by annual screening.

People already diagnosed with diabetic retinopathy may require more frequent examinations. The interval depends on the severity of retinal damage and the ophthalmologist's assessment. A comprehensive examination helps specialists identify changes that might otherwise remain unnoticed. Depending on the findings, doctors may recommend retinal photography, optical coherence tomography (OCT) or other investigations to assess the extent of damage. These tests help determine whether the patient needs monitoring, medication-based treatment or a retinal procedure.

"Diabetic eye care often requires regular screening and timely retinal evaluation, as the nature and progression of the condition can vary from person to person. Specialised care may include procedures such as intravitreal injections, laser treatment and vitreoretinal surgery, depending on individual clinical assessments," Centre For Sight's Dr. Lalit Verma said.

Can diabetic eye damage be prevented?

Not every case of diabetic eye disease can be prevented. However, maintaining good overall health and controlling diabetes can significantly reduce the risk of complications and help slow disease progression. People living with diabetes should pay attention to the following measures:

• Keep blood sugar levels within the target range recommended by their treating doctor.
• Monitor blood pressure and cholesterol regularly.
• Take prescribed diabetes medication consistently.
• Follow a balanced diet and maintain regular physical activity.
• Avoid smoking, which can further affect vascular health.
• Attend scheduled retinal examinations, even when eyesight appears normal.
• Follow the ophthalmologist's advice on monitoring and treatment.

These measures should work together rather than being treated as separate healthcare goals. Good glucose control remains important, but it cannot replace regular eye examinations.

What happens if diabetic retinopathy is detected?

Treatment depends on the stage of diabetic eye disease and the extent of retinal damage. Not every patient requires an immediate procedure. Some people with early-stage diabetic retinopathy may only need regular monitoring and better control of their underlying health conditions.

For patients with diabetic macular oedema or certain advanced forms of diabetic retinopathy, doctors may recommend anti-VEGF injections. These medicines are administered inside the eye to control abnormal blood vessel activity and reduce fluid leakage.

Laser treatment is another option in selected cases. It helps manage abnormal retinal blood vessels and reduces the risk of further complications. In advanced cases involving significant bleeding or tractional retinal detachment, a surgical procedure called vitrectomy may become necessary. The procedure helps remove blood from the vitreous cavity and address complications affecting the retina.

The treatment approach depends on individual clinical findings. Early diagnosis generally provides doctors with more opportunities to manage the condition before substantial vision loss occurs.