Diabetic retinopathy is asymptomatic until it threatens sight, so it has to be caught by screening rather than by waiting for symptoms. Every person with diabetes needs a defined schedule, not an ad hoc check when they happen to mention their vision.
Screen at diagnosis in type 2 diabetes — because retinopathy may already be present — and from five years after onset in type 1, then at least annually, with tighter intervals once retinopathy appears or in pregnancy. A dilated fundus examination or validated retinal photography both work; what matters is that it happens on time and that sight-threatening disease is referred promptly.
In India's large and growing diabetic population, where screening coverage is low and presentation is often late, building this into every diabetic review is among the highest-yield things a clinician who sees these patients can do.
- Screen at diagnosis in type 2 diabetes and from 5 years after onset in type 1, then at least annually.
- Tighten intervals once any retinopathy appears, and screen in pregnancy.
- Use dilated fundoscopy or validated retinal photography — the key is that it happens on schedule.
- Refer sight-threatening or maculopathy findings promptly rather than rechecking later.
Why it matters
Diabetic retinopathy is silent until late, so only scheduled screening catches it while treatment still preserves sight.
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