'Diabetic Retinopathy Is Not Reversible. Treatment And Early Detection Can Control And Slow Progression': Dr. Chaitra Jayadev, Renowned Eye Specialist
The Bengaluru-based ophthalmologist says that the most critical yet often overlooked complication in diabetes patients is an eye condition called diabetic retinopathy.
By Anubha Jain
Published : April 30, 2026 at 2:14 PM IST
India carries one of the world’s largest diabetes burdens, with over 100 million diabetics and 130 million pre-diabetic individuals. The scale of the crisis has earned the country the label of the “diabetes capital of the world”. Diabetic retinopathy affects 12.5%-17% of patients, with 3% to 4% at risk of vision-threatening disease, translating to nearly 12-17 million affected Indians. The urban–rural gap is narrowing, with prevalence at 17.4% and 14%, respectively.
With these statistics in mind, Anubha Jain reached out to Dr. Chaitra Jayadev, Senior Consultant in the Vitreo-Retina Department at Narayana Nethralaya Eye Institute for her insights, as part of ETV Bharat's campaign against diabetes. She pointed out that while clinical management of diabetic eye disease in India is on par with global standards, limited access and affordability continue to hinder timely screening at the community level. She stressed that integrating basic retinal screening into every diabetic centre and primary healthcare facility could significantly improve early diagnosis, calling for urgent policy-level intervention.
A distinguished clinician-researcher based in Bengaluru, Dr. Jayadev has contributed extensively to the field of retinal diseases, particularly diabetic retinopathy, with close to 200 international publications and global training experience. Excerpts from the exclusive interview:
Q 1. How serious is the impact of diabetes on eye health, particularly in India today?
India is emerging as a global capital of diabetes, making awareness and preventive care more important than ever. The most critical yet often overlooked complication is diabetic retinopathy, a serious eye condition that can lead to vision loss if not detected early. Every individual with diabetes is at risk of eye complications, regardless of type: Type 1, Type 2 or gestational. Additionally, an emerging concern is Type 5 diabetes, which is being linked to undernutrition, particularly among young individuals. Adolescents who severely restrict their diet due to weight concerns may be at risk of developing this condition.
With India’s large and growing young population, it is crucial to raise awareness about these risks. Early screening, regular eye check-ups, and proper nutrition are essential to prevent long-term complications and protect vision.
Q 2. What is diabetic retinopathy in simple terms?
Diabetic retinopathy is a condition that affects the retina, the light-sensitive layer at the back of the eye. Since diabetes damages small blood vessels (microangiopathy), the retinal vessels become weak and dysfunctional.
Q 3. How does it impact vision over time? What early symptoms should patients watch for?
Diabetic retinopathy can lead to:
- Fluid leakage (edema), causing blurred vision and difficulty in reading or recognizing faces
- Reduced blood supply (ischemia) due to narrowed vessels
- Abnormal new vessel growth, which can bleed if untreated
Common symptoms include blurred vision, distortion, floaters, and difficulty in daily activities like reading and driving. Not all floaters indicate the presence of diabetic retinopathy. However, in diabetic patients, sudden black or red spots (floaters) may signal bleeding in the eye and require immediate evaluation.
You shouldn't wait for symptoms but be aware of them. Screening is key and should follow a structured schedule based on the time of diagnosis and the severity of diabetic retinopathy (non-proliferative: mild, moderate, severe, very severe, or proliferative). Annual eye check-up is essential, even if there are no symptoms or active disease. Immediate evaluation is needed if symptoms develop. During treatment, follow-ups may be more frequent: weekly, monthly, or as advised, depending on whether you are receiving injections, undergoing laser treatment or have been advised surgery.
Q 4. Why is diabetic retinopathy often called a silent vision killer?
Vision symptoms appear only when the central retina is affected or the disease is already severe. In many Indians, peripheral retinopathy affects the outer retin or periphery, gets impacted earlier in the disease and progresses silently without symptoms. Hence, patients often remain unaware until vision is significantly impacted.
Q 5. Is diabetic retinopathy reversible if detected early?
Diabetic Retinopathy isn't reversible. Treatment and early detection can control and slow progression, but cannot restore the retina to normal.
Q 6. Can technologies like AI help in early detection and large-scale screening of diabetic retinopathy?
It can be screened easily through two main approaches. The gold standard is a dilated eye examination in hospitals, where specialists use eye drops to dilate the pupil and examine the retina to detect even the smallest lesions. However, given the large number of people affected, hospital-based screening alone is not sufficient. In community settings, wide-field imaging or non-dilated retinal imaging (fundus photography) offers a faster and more scalable solution. Trained technicians can capture these images without dilation, which can then be assessed manually or analyzed using AI tools. This approach enables large-scale screening and early detection of the disease.
Q 7. How does the duration of diabetes influence the risk and severity of retinal damage?
The single most important non-modifiable risk factor for diabetic retinopathy is the duration of diabetes. It’s a cumulative effect, where prolonged high sugar levels cause irreversible damage to retinal blood vessels. Even with good sugar control, patients with long-standing diabetes (20-30 years) may still develop some degree of retinopathy. The severity may vary, but some changes are often inevitable over time.
Q 8. With diabetes rising in younger populations, are retinal complications appearing earlier too?
If the question is whether diabetic retinopathy is being seen earlier in the course of diabetes and in younger patients, the answer is yes to both.
There are several reasons for this:
- Rising diabetes in younger age groups (25–30 years)
- Improved screening and earlier detection
- Late diagnosis with existing complications
- Lifestyle factors: obesity, sedentary habits, hypertension, high cholesterol
Together, these factors are contributing to the earlier onset and detection of diabetic retinopathy.
Q 9. Which diabetic patients are at highest risk of retinal complications, and how do hypertension and high cholesterol worsen it?
Key risk factors for diabetic retinopathy include:
- Comorbidities: Conditions like hypertension and high cholesterol.
- Younger age at onset (longer disease duration)
- Pregnancy (faster progression, closer monitoring)
- Poor glycemic control: High blood sugar levels significantly increase the risk and complications.
These factors make regular monitoring and strict control of systemic conditions essential.
Q 10. How can individuals with diabetes protect their vision? Are lifestyle changes enough?
Many patients try to manage diabetes through diet alone, avoiding medication but high blood sugars require medical treatment, since lifestyle changes alone are not sufficient. While concerns about lifelong use and side effects are understandable, diabetes is a chronic condition where medications are needed to normalize sugars, but diet, exercise, and weight management remain essential. Management also depends on the type of diabetes:
- Type 1 diabetes: Insulin is essential, as the body does not produce it.
- Type 2 diabetes: Often involves insulin resistance, which can be improved with lifestyle changes, though medications are still needed in many cases.
Medication and lifestyle modifications go hand in hand for effective diabetes control.
Q 11. What are the latest advancements in diagnosing and managing diabetic eye diseases?
Diagnosis is the first step, and technology has made it much easier. Today, we use wide-field fundus screening (without dilation) to capture retinal images, along with advanced, non-invasive tests like OCT-A, which can visualize blood vessels without dye. AI support further enhances early and accurate detection.
Treatment depends on severity:
- Eye drops: for early, mild retinal swelling (edema)
- Injections: when swelling is more significant
- Laser therapy: for abnormal new blood vessels
- Surgery: in advanced cases with bleeding or retinal detachment
Q 12. How accessible and affordable are advanced treatments for patients across India?
Treatment for diabetic retinopathy is advanced and effective, but access and affordability remain major barriers, with most options concentrated in urban centres and limited insurance coverage. The bigger gap, however, is awareness. Many patients, even in cities, are unaware that diabetes can damage the eyes, leading to delayed diagnosis, with many patients coming at advanced stages. A common misconception is that diabetes affects only blood sugar, not vital organs like the eyes or kidneys. Early patient education at diagnosis is essential. Clear guidance preferably in local languages on complications and timely specialist consultation can help patients seek care earlier and prevent irreversible vision loss.
Q 13. How important is global collaboration in advancing diabetic eye care, and how does India compare globally in screening and management?
Global collaboration is crucial. In terms of clinical diagnosis and management, India is on par with global standards and often treats a higher volume of advanced cases due to a larger population, higher diabetes burden and later patient presentation. In contrast, better healthcare access in the West enables earlier diagnosis and less need for advanced treatment.
India also plays a key role in clinical research, contributing significant data and serving as a major partner for ongoing studies and trials, allowing patients access to emerging advanced treatments.
However, the gap lies in early detection. If screening is made mandatory for every diabetic patient, India would match global standards not just in treatment but also in timely diagnosis. We already have the technology and expertise, including low-cost retinal screening devices and innovations, but adoption (especially in the public health system) remains limited. Stronger healthcare policies and wider screening access are essential, and the media and campaigns like ETV Bharat's can play a powerful role in driving awareness and policy change to prevent irreversible blindness.
Also read:
- Doctors Warn Diabetes Can Cause Diabetic Retinopathy, A Deterioration In Vision
- Diabetes Treatment After 65: Study Finds Newer Meds May Be Safer For The Elderly
- Nearly 1 In Every 3 Indians Is At Risk Of Diabetes, With Andhra Pradesh At Highest Risk Of 56.9%: Report
- Meet Dr. Umesh Chandra Pant, The Cycling Doc From Ghaziabad Who Beat Pre-Diabetes By Pedalling
