India's 100M diabetics face silent vision threat from retinopathy

More than 100 million Indians are living with diabetes right now, and that number keeps climbing. But the conversation about diabetes in this country has a blind spot—literally. While doctors and patients focus on managing blood sugar, one of the most serious complications of the disease moves through the body almost silently: diabetic retinopathy, a condition that damages the tiny blood vessels in the retina and stands as one of the leading preventable causes of blindness among working-age adults.

The mechanics are straightforward and grim. High blood sugar, sustained over years, erodes the delicate network of vessels at the back of the eye. The damage accumulates without fanfare. A person can lose significant vision before they notice anything is wrong. Nearly everyone with Type 1 diabetes will develop some degree of retinopathy in their lifetime. Among those with Type 2 diabetes—the far more common form in India—about 60 percent will experience it. The longer someone has diabetes, the higher the risk climbs.

The disease unfolds in stages, each one a step deeper into trouble. It begins with small changes in the blood vessels that cause no symptoms at all. As it progresses, more vessels become blocked, starving the retina of oxygen. The eye responds by trying to grow new vessels, but these are fragile and prone to bleeding. Scar tissue forms. The macula—the part of the retina responsible for sharp, central vision—swells. In the worst cases, the retina detaches entirely. Some people notice blurred vision, dark spots, or difficulty seeing at night. Many notice nothing until the damage is already severe.

This is where the tragedy deepens: early detection works. Annual eye screening can catch retinopathy before it causes irreversible harm. Medical experts say that catching the disease early and treating it promptly can reduce the risk of severe vision loss by up to 95 percent. Yet most people with diabetes in India are not getting screened. Dr. Manisha Agarwal, head of retina services at Dr. Shroff's Charity Eye Hospital in New Delhi, emphasizes that people with Type 1 diabetes should have their first eye exam five years after diagnosis, while those with Type 2 should be screened at the time of diagnosis and then annually, regardless of whether they notice any symptoms. She notes that controlling blood sugar, blood pressure, and cholesterol can slow the disease's progression once it has begun, but the key is catching it early.

Recognizing this gap between what could be prevented and what is actually being prevented, Sun Pharma has launched a nationwide campaign called #SeeBeyondSugar, backed by the Vitreo Retinal Society of India. The initiative is organizing roughly 300 eye screening camps across 28 cities, using AI-powered technology that can diagnose retinopathy quickly and without the need for pupil dilation. The goal is straightforward: shift how Indians think about diabetes management. It is not just about the numbers on a blood glucose meter. It is about preserving the ability to see.

The stakes are personal and profound. Diabetes may be a lifelong condition, but the blindness it can cause is preventable. A single eye exam once a year—a small investment of time—could be the difference between a life lived fully and one constrained by vision loss. For 100 million Indians already living with diabetes, and millions more who will develop it, that difference matters.