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By Dr Arun Singhvi

As India changes its food consumption habits with fast food joints mushrooming everywhere, it points to not only a mapping of consumer profiling but also a fundamental shift in health indicators in the country. Take obesity, for instance. Roughly one in four Indian adults is overweight or obese, with more recent data from a 2023 Lancet study showing that about one in four adults has generalised obesity and one in three has abdominal obesity.   

Obesity brings with it a host of other health-related issues, such as diabetes, which affects all organs, including the eyes. India currently has an estimated 10.1 crore people with diabetes, of whom about 1.26 crore are believed to have eye-related complications and nearly 40 lakh face the danger of irreversible blindness.

At present, 85 % of diabetics in India are unaware that their condition can impair vision and have never undergone a retinal check. Obesity can also significantly increase the risks of diabetic retinopathy, a major risk of which is blindness. The magnitude of this can be assessed by news reports that indicate that in the coming two decades, the number of Indians facing the threat of going blind due to diabetic retinopathy could exceed the entire population of Sri Lanka.

Data further highlights that by 2045, over 125 million Indians will be living with diabetes. Of these, over 21 million people are slated to develop diabetic retinopathy. Data also show that 5-6 million people may lose their eyesight if timely action is not taken.

Against this backdrop, it is heartening to see that the government recently released Revised National Guidelines for the Management of Diabetic Retinopathy (2025). These guidelines aim to increase awareness by raising diabetic retinopathy screening rates to 80% and ensuring at least a 50% follow-up. India’s latest national survey of 93,000 people shows that only 10% people undergo diabetic retinopathy screening. This is far below the 80% target by 2030, as established by WHO/SEARO (World Health Organization South East Asia Regional Office).

Besides government programmes inculcating these habits, people should be made aware of these conditions and how eye health cannot be treated in silos. Regular checkups should be encouraged to detect early diagnosis and work on treatment. Proper care should also be given to healthy lifestyles, including food habits and exercise. The causes are type 1 diabetes, generally in children and young adults, and type 2 diabetes, which normally occurs in adults and is related to lifestyle factors.

The longer a person has had this disease, the higher his or her chance of developing diabetic retinopathy. Long-term high blood sugar levels spur this damage to the blood vessels in the retina.

One more inclusion in the list of risk factors for the development of diabetic retinopathy is poor blood glucose control. A fasting blood sugar level that is too high or fluctuating can speed up the progression of the disease.

Blood pressure again forms a major risk factor for diabetic retinopathy. If a person has high blood pressure, that certainly strains blood vessels throughout their body, and this also includes the vessels in the retina; they will be more prone to damage caused by diabetes. Besides, high levels of cholesterol, triglycerides, and other blood lipids can enhance the progression of diabetic retinopathy. This is partly mediated through vascular damage and an increase in inflammation.

Optimum management of diabetes with lifestyle modification and medications should be instilled among people. This includes a good diet and exercise, besides insulin or oral medications. Better glycaemic control will slow down the progression of diabetic retinopathy and decrease the incidence of potential blindness.

Being aware of facts about diabetic retinopathy and having regular diabetic retinopathy screenings, accompanied by early intervention, is key to maintaining vision and ensuring general eye health for persons with diabetes. By being proactive in managing diabetes and living a good life, people can dramatically reduce their risks and maximise their chances of good eye health. Better living can be practised one step, one eye checkup at a time.

(The author is MD & CEO, ASG Eye Hospital)

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