Skip to main content


Log in

Proportion of diabetic retinopathy among diabetics presenting for the first time to a tertiary eye institute in South India

  • Original Paper
  • Published:
International Ophthalmology Aims and scope Submit manuscript



To detect the proportion of diabetic retinopathy (DR) among diabetics visiting a tertiary eye care institute and correlate presenting symptoms to clinical diagnosis.


The study recruited 1000 eyes of 1000 diabetics visiting a tertiary eye care institute in South India for the first time. Along with basic demographic data and systemic history, details of presenting complaints and clinical diagnosis were noted.


Data from 956 cases were analyzed. There were 29 (3%) newly diagnosed diabetics and 927 (97%) known diabetics. The commonest reason for the hospital visit was diminution of vision (66%) followed by “visiting for a routine checkup” (22.3%). Diabetic retinopathy was seen in 492 (51.5%), cataract in 161(17%) and refractive error in 240 patients (79.2%). Vision-threatening DR was present in 216 cases (22.59%) and clinically significant macular edema in 73 cases (7.63%) at first presentation itself.


The cohort from a tertiary eye care institute has higher proportion of diabetic retinopathy, with vision-threatening DR at presentation. These data emphasize the need for more robust screening for DR, along with population awareness programs.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
EUR 32.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or Ebook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

Data availability

Data are available at


  1. Flaxman SR, Bourne RRA, Resnikoff S, Ackland P, Braithwaite T, Cicinelli MV et al (2017) Global causes of blindness and distance vision impairment 1990–2020: a systematic review and meta-analysis. Lancet Glob Health 5(12):e1221–e1234

    Article  Google Scholar 

  2. Leasher JL, Bourne RRA, Flaxman SR, Jonas JB, Keeffe J, Naidoo K et al (2016) Global estimates on the number of people blind or visually impaired by diabetic retinopathy: a meta-analysis from 1990 to 2010. Diabetes Care 39(9):1643–1649

    Article  Google Scholar 

  3. Mazhar K, Varma R, Choudhury F, McKean-Cowdin R, Shtir CJ, Azen SP (2011) Severity of diabetic retinopathy and health-related quality of life. Ophthalmology 118(4):649–655

    Article  Google Scholar 

  4. Looker HC, Nyangoma SO, Cromie D, Olson JA, Leese GP, Black M et al (2012) Scottish Diabetic retinopathy screening collaborative; Scottish Diabetes Research Network Epidemiology Group. Diabetic retinopathy at diagnosis of type 2 diabetes in Scotland. Diabetologia 55(9):2335–42

    Article  CAS  Google Scholar 

  5. Cavan D, Makaroff L, da Rocha FJ, Sylvanowicz M, Ackland P, Conlon J et al (2017) The Diabetic Retinopathy Barometer Study: Global perspectives on access to and experiences of diabetic retinopathy screening and treatment. Diabetes Res Clin Pract 129:16–24

    Article  CAS  Google Scholar 

  6. Oommen AM, Kapoor N, Thomas N, George K (2019) Prevalence and clinical characteristics of individuals with newly detected lean diabetes in Tamil Nadu, South India: a community-based cross-sectional study. Int J Diabetes Dev Ctries 39(4):680–684

    Article  Google Scholar 

  7. American Diabetes Association (2014) Diagnosis and classification of diabetes mellitus. diabetes care. 37(Supplement_1):S81–S90.

  8. Chylack LT (1989) Lens Opacities Classification System II (LOCS II). Arch Ophthalmol 107(7):991

    Article  Google Scholar 

  9. (1991) Grading diabetic retinopathy from stereoscopic color fundus photographs—an extension of the modified Airlie house classification. Ophthalmology. 98(5):786–806.

  10. Sivaprasad S, Gupta B, Crosby-Nwaobi R, Evans J (2012) Prevalence of diabetic retinopathy in various ethnic groups: a worldwide perspective. Surv Ophthalmol 57(4):347–370

    Article  Google Scholar 

  11. Varma R, Choudhury F, Klein R, Chung J, Torres M, Azen SP (2010) Four-year incidence and progression of diabetic retinopathy and macular edema: the Los Angeles latino eye study. Am J Ophthalmol 149(5):752-761.e3

    Article  Google Scholar 

  12. Thapa R, Paudyal G, Maharjan N, Bernstein P (1970) Demographics and awareness of diabetic retinopathy among diabetic patients attending the vitreo-retinal service at a tertiary eye care center in Nepal. Nepal J Ophthalmol 4(1):10–16

    Article  Google Scholar 

  13. Rema M, Premkumar S, Anitha B, Deepa R, Pradeepa R, Mohan V (2005) Prevalence of Diabetic Retinopathy in Urban India: The Chennai Urban Rural Epidemiology Study (CURES) Eye Study, I. Investig Opthalmol. Vis Sci 46(7):2328

    Article  Google Scholar 

  14. Thapa R, Joshi DM, Rizyal A, Maharjan N, Joshi RD (2014) Prevalence, risk factors and awareness of diabetic retinopathy among admitted diabetic patients at a tertiary level hospital in Kathmandu. Nepal J Ophthalmol 6(1):24–30

    Article  Google Scholar 

  15. Narendran V, John RK, Raghuram A, Ravindran RD, Nirmalan PK, Thulasiraj RD (2002) Diabetic retinopathy among self-reported diabetics in southern India: a population based assessment. Br J Ophthalmol 86(9):1014–1018

    Article  CAS  Google Scholar 

  16. Raman R, Rani PK, Reddi Rachepalle S, Gnanamoorthy P, Uthra S, Kumaramanickavel G et al (2009) Prevalence of diabetic retinopathy in India. Ophthalmology 116(2):311–318

    Article  Google Scholar 

  17. Rema M, Ponnaiya M, Mohan V (1996) Prevalence of retinopathy in non insulin dependent diabetes mellitus at a diabetes centre in Southern India. Diabetes Res Clin Pract 34(1):29–36

    Article  CAS  Google Scholar 

  18. Krishnaiah S, Das T, Nirmalan PK, Shamanna BR, Nutheti R, Rao GN et al (2007) Risk factors for diabetic retinopathy: Findings from The Andhra Pradesh Eye Disease Study. Clin Ophthalmol 1(4):475–482

    PubMed  PubMed Central  Google Scholar 

  19. Ramachandran A, Snehalatha C, Vijay V, King H (2002) Impact of poverty on the prevalence of diabetes and its complications in urban southern India: Original article. Diabet Med 19(2):130–135

    Article  CAS  Google Scholar 

  20. Kempen JH, O’Colmain BJ, Leske MC, Haffner SM, Klein R, Moss SE et al (2004) Eye Diseases Prevalence Research Group. The prevalence of diabetic retinopathy among adults in the United States. Arch Ophthalmol. 122(4):552–63

    Article  Google Scholar 

  21. Zhang X, Saaddine JB, Chou C-F, Cotch MF, Cheng YJ, Geiss LS et al (2010) Prevalence of Diabetic Retinopathy in the United States, 2005–2008. JAMA 304(6):649

    Article  CAS  Google Scholar 

  22. Kohner EM, Aldington SJ, Stratton IM, Manley SE, Holman RR, Matthews DR et al (1998) United Kingdom Prospective Diabetes Study, 30. ARCH OPHTHALMOL 116:7

    Article  Google Scholar 

  23. Matuszewski W, Baranowska-Jurkun A, Stefanowicz-Rutkowska MM, Modzelewski R, Pieczyński J, Bandurska-Stankiewicz E (2020) Prevalence of Diabetic Retinopathy in Type 1 and Type 2 Diabetes Mellitus Patients in North-East Poland. Medicina (Mex) 56(4):164

    Article  Google Scholar 

  24. Keel S, Xie J, Foreman J, van Wijngaarden P, Taylor HR, Dirani M (2017) The Prevalence of Diabetic Retinopathy in Australian Adults with Self-Reported Diabetes. Ophthalmology 124(7):977–984

    Article  Google Scholar 

  25. Sparrow JM, McLeod BK, Smith TDW, Birch MK, Rosenthal AR (1993) The prevalence of diabetic retinopathy and maculopathy and their risk factors in the non-insulin-treated diabetic patients of an English town. Eye 7(1):158–163

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations



MDS was involved in the conceptualization, methodology, supervision, visualization, writing—reviewing and editing. TS was involved in the data curation and writing original draft. SS contributed to the methodology, writing—reviewing and editing. DY was involved in the writing—original draft.

Corresponding author

Correspondence to Manavi D. Sindal.

Ethics declarations

Conflict of interest

The authors have no financial or non-financial interests to declare.

Ethical approval

The study was approved by the Institutional Review Board, Aravind Eye Hospitals Scientific committee, IRB Code: IRB201400169. The study adhered to the tenets of the declaration of Helsinki.

Informed consent

Informed consent was obtained from all participants.

Clinical trial registration

This was a cross-sectional observational study. Clinical trial registration is not necessary for this study.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Presented as a paper at AIOC 2018, 76th Annual Conference of the All India Ophthalmological Society, February 22-25th, Coimbatore, India.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sindal, M.D., Sathe, T., Sengupta, S. et al. Proportion of diabetic retinopathy among diabetics presenting for the first time to a tertiary eye institute in South India. Int Ophthalmol 41, 2789–2796 (2021).

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: