As we all know, with the improvement of people’s living standard and the change of diet structure, the prevalence of diabetes in our population is increasing, and it has become a common disease that seriously affects people’s physical and mental health, and diabetic retinopathy is one of the most important clinical manifestations of diabetic microangiopathy, which is a more common blinding eye disease. More than half of the patients with a history of diabetes for more than 10-15 years develop retinopathy. Diabetic retinopathy is a leaky, occlusive, and proliferative microangiopathy that occurs in the retinal tissue of the eye to the point where neovascularization occurs in the retinal tissue due to ischemia and hypoxia. Clinically, the disease is divided into two main stages of development, namely the nonproliferative and proliferative phases of the disease, depending on whether neovascularization occurs in the retina. In the non-proliferative phase, the patient’s retina shows microangiomas, hemorrhagic spots, hard exudates, and cotton wool spots. The main hazard of this stage lesion is the leakage of plasma components into the retinal tissue due to the disruption of the blood-retinal barrier, resulting in retinal edema, and when the edema occurs in the macula, it causes central visual impairment. At this time, the lesion is still in the early stage of the disease, and local laser photocoagulation is mostly used to treat macular edema and exudation. Studies have confirmed that local laser photocoagulation can reduce more vision loss and increase the chance of visual progress. When the lesion progresses to a large area of retinal vascular atresia, the lesion has begun to progress to the proliferative stage and whole retinal dissemination photocoagulation should be performed promptly. The most important fundus changes of proliferative diabetic retinopathy are neovascularization and corresponding complications, mainly manifested by the growth of proliferating neovascularization along the retinal surface or into the vitreous to form a proliferative membrane. When the neovascularization ruptures, it can lead to retinal and vitreous hemorrhage, and the contraction of the proliferating membrane can also cause retinal detachment by traction, at which time, the patient’s vision is seriously affected. In the early stage of this lesion, if there is not yet a large amount of vitreous hemorrhage and retinal detachment, the whole retina can be treated by whole retinal diffusion photocoagulation alone, and the formed neovascularization can still regress if treated properly. However, if vitreous hemorrhage or retinal detachment is combined and the vitreous hemorrhage is not absorbed for a long time (usually observed for 3 months), vitrectomy should be considered. The purpose of surgery is to remove the accumulated blood, cut off the mechanized membrane, eliminate the scaffold on which the fibrous tissue grows, loosen the retinal traction, fill the vitreous cavity with silicone oil or gas if necessary, restore the normal retinal anatomy, and perform total retinal photocoagulation during or after surgery. The prognosis of advanced diabetic retinopathy cannot be generalized. Patients should go to a qualified hospital as early as possible for detailed examination, including slit lamp, fundoscopy, ultrasound, and visual electrophysiology, in order to fully assess the extent of the lesion and the functional status of the retina, weigh the pros and cons, and decide whether to operate. In some patients, although central vision may not be restored after surgery, the visual field may be expanded, which is still important for patients with severe lesions in both eyes or those who are already blind in one eye. In conclusion, when you discover that you have diabetic retinopathy, it is important to take it very seriously. The most fundamental treatment is to control diabetes. Blood glucose should be controlled to normal range by diet or combined with hypoglycemic drugs as much as possible, and insulin should be applied under the guidance of endocrinologist if necessary. Ophthalmic treatment should be carried out in stages according to the condition. At present, due to the continuous improvement and perfection of laser and surgical treatment methods and equipment, many patients with advanced diabetic retinopathy originally considered incurable can still recover some of their vision. Therefore, both doctors and patients should build up confidence and strive for early treatment and the best possible outcome.