Why retinal health must be at the heart of India’s vision agenda

India’s fight against blindness has come a long way. Decades of public health initiatives have helped eliminate several major eye diseases and restore sight to millions. Yet, even today, our country continues to carry the burden of being called the blindness capital of the world —home to nearly one-third of the global blind population.

A large and growing share of this burden now stems from a less visible, but far more insidious cause: retinal diseases.These conditions, which affect the delicate light-sensitive layer at the back of the eye, are quietly rising across India. Currently, more than 1.1 crore Indians live with retinal disorders and over 40 lakh are already battling advanced Diabetic Retinopathy (DR)—a diabetes-related eye disease that can lead to irreversible blindness if not detected early.

Shockingly, only about 2 lakh among them are receiving treatment.This widening gap between disease and diagnosis reflects a dangerous combination of low awareness, late detection, and limited access. India has over 100 million people with diabetes and 136 million pre-diabetics. Yet, studies show that 85% of them have never had their retina examined and nearly half of those with DR lose their vision before they are even diagnosed.

Retinal diseases progress silently—without pain, redness, or warning. Most patients notice blurring, floaters, or wavy lines only after permanent damage has set in.The good news is that blindness from DR is largely preventable—if caught in time. Retinal screening is quick, painless, and inexpensive. Western countries have shown that routine retinal checks as part of diabetes management can halve the incidence of sight-threatening DR.

Unfortunately, India is yet to integrate such screening into its national non-communicable disease (NCD) programs.To change this, we must build screening capacity at the grassroots, train healthcare workers in retinal imaging and diagnosis and create seamless referral pathways linking primary physicians, diabetologists and retina specialists. Early detection coupled with a robust referral network can make all the difference.Equitable access to treatment is equally vital. Modern therapies, including intravitreal injections and advanced bispecific antibodies, can now target multiple disease pathways—reducing inflammation, preventing abnormal vessel growth and preserving sight with fewer treatment cycles. India has already demonstrated that strong policy, public awareness and collaborative action can conquer health challenges—from polio to cataract blindness. We must now bring the same resolve to retinal health. By making retinal screening a national priority, integrating it into the journey of every person with diabetes and ensuring timely treatment for all, we can truly move towards a vision-secure India.Let us remember: the path to preventing blindness begins long before symptoms appear. Retinal health is not just an eye issue—it is a national imperative.

Dr Padmaja Kumari Rani, Network Associate Director, L V Prasad Eye Institute