2 days ago
Can't Turn Blind Eye To Diabetic Retinopathy
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ew Delhi: India, often labelled the diabetic capital of the world, faces an alarming crisis with over 77 million people diagnosed with diabetes and 25 million as pre-diabetics.
In 2019 alone, India recorded a staggering one million diabetes-related deaths. The most notable complication for diabetics is diabetic retinopathy (DR), an eye condition resulting from damage to retinal blood vessels caused by high blood sugar.
Shockingly, 16.9% of diabetic individuals suffer from DR and 3.6% are at imminent risk of complete vision loss. Leading experts in the field say that without swift, decisive action in screening and treatment, the prevalence of blindness due to DR will escalate.
AT the round table hosted by The Times of India on Wednesday, experts said that the time to act was now — delays would cost not only money, but sight and lives. The experts called for DR screening to be made a fundamental right for diabetic patients by 2030.
Experts flagged early detection as the most effective way to stop DR-related vision loss. They stressed the urgent need for training frontline health workers and equipping primary care centres with screening tools like fundus cameras.
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They wanted DR prioritised under the National Non-Communicable Disease Programme to ensure it became a core part of routine diabetic care across all health systems. They were emphatic about DR screening under Ayushman Bharat, currently operational in only 12 states, being rolled out nationwide without delay.
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Public awareness was another major gap. "Most diabetics don't know DR exists until they lose vision," experts said, urging large-scale awareness campaigns to promote regular eye checks.
The panel also highlighted the need for accessible and affordable treatment, especially in rural areas, and pushed for stronger public-private partnerships to expand reach and innovation.
India had 101 million diabetics in 2024 — a figure originally projected for 2030 — signifying the alarming pace of the disease's spread. Dr Manisha Agarwal, general secretary, VSRI, and vitreo-retina department head at Dr Shroff's Charity Eye Hospital, noted that nearly half of the world's diabetics lived in China, India and the US.
Dr Chaitra Jayadev, senior consultant, vitreo-retinal services, Narayana Nethralaya, Bengaluru, said that India had national frameworks like the National Control of Visual Impairment and National Programme for Control of Blindness, but stronger policy enforcement was essential to effectively address DR. A national mandate should require diabetologists, endocrinologists and physicians to physically stamp prescriptions with a clear message: "Get your retina screened by an ophthalmologist.
" Many patients skipped screening simply because their doctor didn't advise it, Jayadev pointed out, adding that this gap could only be addressed through govt action.
Taking advantage of the widespread smartphone use, the experts suggested a monthly voice alert reminding diabetics to get their eyes screened. "It's simple, cost-effective and could prevent avoidable blindness," one expert said.
DR remains a neglected health crisis in India, commented Dr Rajni Kant Srivastava, ICMR-chair, disease elimination, founder-director, ICMR-Regional Medical Research Centre, Gorakhpur, and visiting professor at SEARCH, Gadchiroli.
"To bring real change, we must present a strong policy document that identifies existing gaps and actionable solutions," he said. He urged for the integration of diabetic eye care into the national programmes, citing Kerala's successful screening model and the potential of telemedicine in remote areas.
"Retina health is closely tied to the twin silent epidemics of diabetes and hypertension in India," noted Dr Indu Bhushan, independent director, Corporate and Non-Profit Boards, ex-CEO, Ayushman Bharat, ex-director-general ADB and former IAS officer, while calling for preventive screening at health and wellness centres, use of AI-enabled teleophthalmology, and task-shifting to trained non-doctor staff for first-line checks.
He also wanted retinal surgeries included in PM-JAY.
Speaking virtually, Dr K Madan Gopal, advisor on public health administration at NHSRC, a premier think tank of the Union health ministry, said that over 1.7 lakh health and wellness centres were operational for daily consultations. Trained workers conducted initial screenings and connected patients to doctors at district hospitals or medical colleges. "States like Kerala, Andhra Pradesh and Telangana are piloting tele-ophthalmology for diabetic eye care.
Urban centres with stronger infrastructure are also testing this," he said. While implementation was currently limited, he added, the model held promise though scaling it nationally would require significant investment.
Rajwinder Mehdwan, MD & CEO, Roche Pharma India, urged health leaders to frame a sharp, actionable policy to bring DR into govt focus. "We have expertise in public-private partnerships, screening, and treatment access.
But for real change, we need a clear narrative that gets govt's attention — like it did with polio or cataract," she said. She emphasised Roche's readiness to support with proven models and called for unified action to move from problem recognition to policy impact.
Other experts who participated in the round table were Dr Bhavna Chawla, professor, retinoblastoma and ocular oncology services, and Dr Vinod Agarwal, professor, vitreo-retina services, AIIMS, Delhi, Dr Muna Bhende, director, vitreo-retinal services, Sankara Nethralaya, Chennai.
