India has taken a major step toward tackling the rising threat of diabetic retinopathy with the release of revised 2025 guidelines that call for widespread adoption of AI-enabled retinal screening across primary health centres. The recommendations, issued by Right to Sight–India in collaboration with leading ophthalmologists and supported by the All India Ophthalmological Society (AIOS), propose mandatory annual retinal screening for every person living with diabetes.
Why the Guidelines Matter
Diabetic retinopathy—a complication caused by damage to tiny blood vessels in the retina—can affect anyone with type 1 or type 2 diabetes. The risk increases with the number of years a person has diabetes and with poor blood sugar control. The danger lies in its silent progression: most people show no symptoms until the disease has already advanced.
The new guidelines aim to reshape diabetic eye care in India by using a technology-driven, system-wide framework that can help boost screening coverage to 80% of the diabetic population—a major leap from current levels.
What the Experts Say: A Shift Toward Prevention
According to Dr. Vishali Gupta, President of the Vitreo-Retinal Society of India (VRSI), the updated recommendations signal a decisive move toward early and systematic detection. Early intervention, she emphasized, can cut the risk of severe vision loss by up to 50%.
Dr. R. Kim, Chief Medical Officer at Aravind Eye Hospital, highlighted an alarming trend: while cataract and glaucoma were once the leading causes of blindness in India, diabetes-related eye disease is rapidly emerging as a major concern.
Diabetic Retinopathy: A Growing Threat
Although improvements in diabetes care have been made, significant gaps remain in detection and management. Challenges include:
- Poor integration with NCD (non-communicable disease) programmes
- Low public awareness
- Inequitable access to screening
- Underuse of AI tools that can simplify early identification
These shortcomings prompted the revision of the 2025 guidelines to bring stronger surveillance, better technology adoption, and more structured care pathways.
Screening & Treatment: What’s New
At the Primary Level:
- AI-enabled fundus imaging is now recommended as the first-line screening tool.
- Easy to operate, it allows non-specialists to capture retinal images and receive automated AI-based assessments instantly.
At Secondary Centres:
- Usage of Optical Coherence Tomography (OCT) is advised to detect diabetic macular edema, a leading cause of visual impairment.
At Tertiary Care Facilities:
- Access to advanced imaging, including wide-field imaging and other specialized diagnostics, is recommended to support complex cases.
Improving Access to Treatment:
The guidelines stress that essential treatments such as laser therapy, anti-VEGF injections, and bispecific intravitreal injections are to be included under the Ayushman Bharat Pradhan Mantri Jan Aarogya Yojana, reducing financial hurdles for patients.
Strengthening Data & Policy Development
Experts stress the need for national registries for diabetes and diabetic retinopathy. Such databases would support real-time tracking, improved surveillance, and evidence-based policymaking.
With diabetes rates soaring, the 2025 guidelines offer a timely, transformative approach to protecting sight. By combining AI-powered screening, expanded access to treatment, and stronger national oversight, we can prevent blindness caused by diabetic retinopathy.