The fundamental treatment for diabetic retinopathy is the treatment of diabetes mellitus. Whenever possible, blood glucose should be controlled by diet or combination of hypoglycemic drugs to keep it within the normal range. Medication For background stage diabetic retinopathy, that is, stages I to III, diet control and medication are generally used. A low-fat, high-protein diet and more vegetable oils can reduce hard exudate. Small doses of aspirin, which has anti-inflammatory effects and reduces platelet agglutination, are effective in diabetic retinopathy. Calcium hydroxybenzenesulfonate can reduce the hyperleakage reaction of diabetic retinal vessels, lower the high viscosity of blood and reduce the high aggregation of platelets, which also has a certain therapeutic effect on diabetic retinopathy. As a result of the wisdom of traditional medicine in China, Chinese medicines (e.g., Fuxiang Danxiong tablets and other blood-activating drugs) also have clear efficacy in diabetic retinopathy and can slow down the progression of diabetic retinopathy. When macular edema is present in the fundus, local treatment with long-acting hormones, such as subconjunctival or intraocular injections of tretinoin, can also be used, which has clear efficacy in reducing edema and improving vision, but the side effects of treatment, mainly secondary glaucoma and the risk of intraocular infection, should be weighed before treatment. When vitreous hemorrhage is present, hemostatic medications such as Yunnan Baiyao can be administered, and medications to aid absorption, such as lecithin complex iodine (Volitene), can be given. While the effectiveness of short-term blood glucose control on fundus pathology is sometimes not readily apparent, the effectiveness of long-term maintenance of blood glucose at normal levels in preventing diabetic retinopathy is well recognized. Studies have shown that a 2% decrease in glycosylated hemoglobin can reduce the progression of diabetic retinopathy by 70%. In addition, diabetic retinopathy tends to worsen when overall blood glucose levels are comparable and blood glucose fluctuates more, so maintaining a stable normal blood glucose level is very important. Laser treatment For more severe diabetic retinopathy, laser photocoagulation is an effective treatment measure. In background stage diabetic retinopathy, laser treatment mainly treats macular edema and ring exudate lesions to reduce the incidence of persistent macular edema, reduce the risk of degeneration and vision loss, and facilitate the recovery of vision. For severe stage III lesions and proliferative diabetic retinopathy, total retinal photocoagulation is an effective method to reduce vision loss and blindness. The principle of total retinal photocoagulation can be simply summarized as the loss of a pawn to save a chariot. Because the retina is in a state of ischemia in diabetes, the laser can cause scarring of the peripheral retina, a decrease in oxygen consumption throughout the retina, and a significant reduction in the likelihood of neovascularization, thus protecting the macula. Laser treatment is performed with the pupil sufficiently dilated prior to laser treatment, and can be performed under surface anesthesia, usually without much pain. Many diabetic patients have concerns about laser treatment because intraocular hemorrhage does occur in some patients after laser treatment. There are two main reasons for this: first, the patient has a heavy lesion and may bleed with or without laser, and the bleeding is coincidental, and second, the laser itself can have a certain reaction that may cause the patient’s condition to temporarily worsen. When the patient’s condition is severe, retinal condensation can be performed, which can contribute to the stabilization of the condition. Surgery For proliferative diabetic retinopathy, vitreous surgery should be considered if there is recurrent vitreous hemorrhage or persistent non-absorption or pulling retinal detachment. The goal of surgery is to remove the accumulated blood and neovascular membrane and allow the retina to adhere back to the wall of the eye, either with laser or condensation, and the retinal lesion to stabilize. Vitrectomy is one of the more complex surgeries in ophthalmology. It is usually performed under local anesthesia, but can also be performed under general anesthesia if the patient is not cooperating well or is particularly nervous. The surgeon makes three holes in the patient’s eye, about 0.9 mm in diameter, through which the surgeon performs the intraocular surgery. Before the end of the operation, if the patient’s fundus is in good condition, the wound is closed directly and the patient does not require special positions after the operation. If the patient’s fundus is worse, the surgeon fills the patient’s eye with temporary material to allow the retina a period of time to recover. This requires the patient to remain in a special position, usually head down, for 2 weeks to several months after surgery. After vitrectomy, the retinal condition of most patients can be stabilized and some vision can be maintained, thus avoiding many previous cases of blindness as a result. For diabetic patients with abundant neovascularization, intraocular injections of anti-VEGF drugs may also be considered. Laser or vitrectomy treatment is performed after the hemorrhage has been absorbed.