In the last two weeks, we have had five patients in a row, all with diabetic retinopathy in both eyes, and all of them have progressed to the stage of needing total retinal laser photocoagulation in both eyes, and two of them even need to undergo biosurgery to restore some of their vision. When chatting with patients, we found that many diabetic patients do not know that diabetes and ophthalmology are closely related, and they neglect early and regular checkups and fail to achieve early detection and treatment, which brings them to this point. Diabetic retinopathy is the most important manifestation of diabetic microangiopathy, a kind of fundus lesion with specific changes, and is one of the serious complications of diabetes. The incidence of diabetic retinopathy is related to the duration of diabetes, age of onset, genetic factors and control, and the longer the duration of the disease, the higher the incidence. 50% of patients with diabetes diagnosed before the age of 30 develop diabetic retinopathy after 10 years, and 90% after 30 years. 10% of diabetic patients develop fundopathy within 5-9 years of onset, and those with good glycemic control develop diabetic retinopathy later than those with poor glycemic control. Retinopathy occurs later than those with poor glycemic control. 1, clinical manifestations: in the early stage of the lesion, generally no ocular conscious symptoms. With the development of the disease, there are different manifestations, for example, retinal edema can cause light scattering and make patients have a sense of flash in front of the eyes, macular edema, ischemia or exudation involving the central recess can cause different degrees of vision loss with visual distortion, large vision, small vision, etc. Rupture of small retinal arteries and a small amount of hemorrhage into the vitreous can cause patients to feel a black shadow floating in front of their eyes. Neo-vascular growth, massive vitreous hemorrhage or proliferative vitreoretinopathy and tractional retinal detachment can lead to severe loss of vision. 2, need to perfect the examination: (1) fundus examination: regular fundus examination for diabetic patients is the main means to diagnose diabetic retinopathy. Microaneurysms and/or small hemorrhages are always the earliest and more definite signs of retinopathy. A waxy, hard, yellowish-white exudate indicates abnormal function of the vascular system, increased permeability, and escape of blood components. The white soft exudate indicates severe microcirculatory disturbances and vascular destruction. (2) Fundus fluorescence angiography: It not only can understand the early changes of retinal microcirculation, but also has various special manifestations in the progression of diabetic retinopathy, and its positive sign detection rate is higher than that of fundoscopy, which is a reliable basis for early diagnosis and selection of treatment plan, evaluation of efficacy and judgment of prognosis. If diabetic retinopathy has not yet been detected under fundoscopy, abnormal fluorescence patterns can appear on fundus fluorescence angiography Microangiomas detected under fundus fluorescence angiography are much earlier and more numerous than those seen under fundoscopy. (3) OCT: Once macular edema occurs in diabetic patients, it will seriously affect vision. OCT examination, also called optical coherence imaging, is an optical diagnostic technique that can do tomographic imaging of ocular translucent tissue. It can check the degree of macular edema and determine the nature, severity and treatment effect of the lesion. Prevention (1) Strictly control blood sugar within the normal range and avoid too much fluctuation of blood sugar. (2) Diabetic patients should undergo fundus and fluoroscopy at least once every six months to a year to ensure that the problem can be solved in time at the early stage of the lesion and to prevent the lesion from becoming serious. Patients with poorly controlled blood glucose need to have their fundus rechecked once every 3 months or even once a month. If diabetic retinopathy is found to be stage 3 or higher, PRP laser treatment should be performed in both eyes as soon as possible to avoid serious complications.