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Thousands of Diabetics Needlessly Lose Their Sight. Diabetic Retinopathy Is an Overlooked Risk

Diabetes is not just a metabolic disease—its hidden complications can lead to vision loss. Diabetic retinopathy, damage to the retina caused by prolonged high blood sugar levels, is one of the leading causes of blindness in working-age adults across Europe. Experts warn that it is among the most serious yet most frequently overlooked complications of diabetes.

According to the World Health Organization (WHO), approximately 64 million people in the European region have diabetes, and up to one-third of them show signs of visual impairment. Diabetic retinopathy affects one in four diabetics—up to 25.7% of patients in Europe. In the Czech Republic, more than 100,000 patients suffer from this complication, and the real number may be even higher. One of the key issues is the lack of awareness and the underestimation of preventive eye exams, which should be a standard part of care for every diabetic.

“We often see patients who come in only when the changes to the retina are irreversible. Yet early diagnosis and treatment can prevent vision loss,” says Lucie Frantlová, MD, Head of the Retinal and Injection Centre at Eye Centre Prague.

A Disease Without Symptoms Is Especially Dangerous

One of the most insidious aspects of diabetic retinopathy is its silent progression—changes in the retina often occur without any noticeable symptoms. The risk is higher in patients with type 1 diabetes, where the disease may develop earlier and more aggressively (with a prevalence of up to 54.4%). In patients with type 2 diabetes, the changes are often diagnosed later, typically only after vision has worsened.

“The danger of diabetic retinopathy lies in the fact that vision does not deteriorate immediately. Patients often have no idea something is wrong—until it’s too late,” adds Dr Frantlová.

Artificial Intelligence Aireen Is Transforming the Future of Diagnosis

A new hope for early detection of diabetic retinopathy is artificial intelligence, which is beginning to play an important role in ophthalmology. Eye Centre Prague is involved in developing Aireen, a tool that uses deep learning to analyse retinal images.

“The software automatically detects typical pathological changes such as bleeding, swelling, or vascular abnormalities and assesses the severity of the findings as well as the urgency of further steps,” explains Dr Frantlová. “Thanks to this tool, general practitioners and diabetologists can conduct basic screenings without specialised equipment, significantly increasing the chances of early detection.”

AI can greatly improve care for diabetic patients by enabling efficient, regular screenings of large populations—ensuring those who truly need eye care are referred in time, before irreversible damage occurs. AI also helps bridge the gap caused by the shortage of specialists and eases the burden on the healthcare system.

Jiří Kuchyňa, CEO of the company developing Aireen, explains: “Aireen allows early detection of serious diseases outside of specialised eye clinics. It’s especially useful for GPs and diabetologists, who can refer patients to specialised care even before symptoms appear.” The Retinal Centre at Eye Centre Prague directly participated in clinical trials of the Aireen system and supported its development.

Vision Loss Changes Lives

Vision impairment or loss has far-reaching consequences for patients. It affects their ability to work, drive, enjoy hobbies, or take care of themselves. This loss of independence often leads to anxiety, depression, or social isolation.

“Diabetic retinopathy is not just a health issue. Losing vision means losing dignity, independence, and quality of life. Type 1 diabetics are especially at risk—the disease can start developing at a young age. The longer diabetes lasts, especially if poorly managed, the higher the risk of sight-threatening damage with lifelong consequences,” says Dr Frantlová.

Treatment Options: Biological Therapy

When diabetic retinopathy is diagnosed at an advanced stage, modern treatment options are available.

The most significant is biological therapy using intravitreal injections of anti-VEGF agents. These injections reduce swelling and bleeding in the macular region. Their targeted action can help patients with severe forms of the disease, where other treatments may be insufficient. The therapy is usually long-term and requires regular injections. While it may not restore lost vision, it can halt further deterioration and preserve remaining sight. Although such treatment may sound daunting, it is painless and patients can go home just minutes after the procedure.

Prevention Saves Vision—And It’s Covered by Insurance

Prevention of diabetic retinopathy is crucial and can be achieved either through AI-based screening or regular visits to an eye specialist—ideally once a year. Retinal examination is non-invasive, painless, and fully covered by public health insurance.

“There are approximately 1.1 million people with diabetes in the Czech Republic—around 10% of the population. Yet only a small percentage of them visit an eye specialist. As a result, many go untreated and face a high risk of vision loss,” warns Ing. Mgr. Petra Králová, Director of the DIAvize clinic.

Diabetes is one of the fastest-growing chronic diseases in the Czech Republic. According to data from the Institute of Health Information and Statistics (ÚZIS), the number of diabetics has increased by over 90% in the past 20 years—from around 520,000 in 2003 to nearly 990,000 in 2023. If current lifestyle trends and population ageing continue, the number could exceed 1.2 million by 2030—around 12% of the population.

“Prevention is the most effective weapon against diabetes-related vision loss. Early diagnosis and treatment can save the sight of thousands of patients,” concludes Dr Lucie Frantlová.