NEW DELHI: In the next two decades, Indians facing the threat of going blind due to diabetic retinopathy (DR) could well exceed the entire population of Sri Lanka. This may sound alarming, but data indicates that by 2045, more than 125 million Indians will be living with diabetes — and of these, 16.9%, or over 21 million people, are projected to develop diabetic retinopathy. Data also shows that 4% to 5% of all people with diabetes — about 5 to 6 million — may lose their eyesight if timely action is not taken.Aware of this growing threat, the government is seeking to tackle DR through a unified, India-specific framework with the newly released Revised National Guidelines for the Management of Diabetic Retinopathy (2025). The guidelines were launched by VISION 2020 at a one-day National Summit on Diabetic Retinopathy held on Friday, bringing together 200 experts from across the country. The chief guest at the event was Dr VK Paul, member, NITI Aayog.The guidelines aim to boost awareness by raising DR screening rates to 80% and ensuring at least 50% follow-up, anchored in a unified message — “Check yearly and See Clearly.” They recommend leveraging chemists, laboratories, PHCs, corporates, community groups and mass media to reach people with diabetes, supported by counselling, SMS reminders and standard IEC materials. Tele-ophthalmology, AI-based triage and cost-of-blindness modelling are encouraged to improve access, with public dashboards to track screening and follow-up. On treatment, the document outlines a tiered system: primary care centres should focus on diabetes control and referral; secondary centres can initiate anti-VEGF, bispecific IVI, steroids and PRP; and tertiary hospitals will manage advanced disease and surgery. The guidelines also propose mobile laser units, expanded insurance coverage, ABHA-linked records, image-based documentation, strengthening public hospitals under AB PM-JAY, research on emerging therapies and national registries to improve planning and continuity of care.Experts warned that with diabetes appearing earlier, lifetime risk of DR rises steeply — nearly 80% of those living with diabetes for 20 years develop it.Despite this, India’s latest national survey of 93,000 people shows only 10% of diabetics undergo DR screening, far below the WHO/SEARO target of 80% by 2030. DR affects 18% of urban and 10.4% of rural diabetics, putting nearly one in five urban patients at risk of vision loss. Early detection can prevent most blindness, yet awareness remains low.Dr Rajesh Saini said the updated guidelines will strengthen early detection, especially in underserved areas.Dr Praveen Vashist from AIIMS highlighted the cross-sector collaboration driving these efforts.Dr Monika Puri urged all diabetics to get an annual retina check-up, calling DR “largely preventable.”