Currently, there are more and more people with diabetes in China. Diabetes is a systemic metabolic disease that can easily lead to many systemic complications. The most common one in the eye, which has the greatest impact on vision, is diabetic retinopathy (DR). The incidence of diabetic retinopathy gradually increases as the duration of the disease increases. International diabetes research data confirms that the incidence of diabetic retinopathy is 20% to 50% for those who have had diabetes for more than 5 years, 50% for those who have had diabetes for 8 years, and 70% for those who have had diabetes for more than 20 years. And because the course of the disease is irreversible, serious cases lead to blindness, which is extremely harmful to the eyes. Research data shows that the number of blindness caused by diabetic retinopathy is 25 times higher than that of non-diabetic patients. The early stages of diabetic retinopathy can be asymptomatic, but as the disease progresses, the vision becomes significantly blurred until complete blindness. Some patients can suddenly go blind, mainly because of vitreous hemorrhage or retinal detachment; some patients may also have eye pain, eye swelling symptoms at the same time as blindness, which may have occurred more serious complications – secondary glaucoma. The pathological basis of diabetic retinopathy is microangiopathy, and DR is often divided into two types: simple and proliferative, and each type is divided into three stages. Microangiomas, hard exudates and cotton wool spots and hemorrhages can occur in the simple stage. Proliferative retinopathy occurs when neovascularization occurs in the retina. Because the walls of the neovascularization are very fragile, it is very easy to develop vitreous hemorrhage and further proliferative retinal detachment, so patients can experience a sudden and significant loss of vision. Neovascularization can also lead to secondary glaucoma, which causes eye pain, eye distention and eventually blindness. At this time, even if the blood sugar is controlled, the systemic state has improved, but also can not make the eye pathological process reversed, must be combined with eye laser or surgical treatment, in order to make the lesion stable. 3. Severity of DR The rate of ocular blindness in diabetic patients is very high and has become a major cause of adult blindness in developed countries. Currently, many patients are not aware of diabetes and its eye complications, and some patients only find out they have diabetes when they come to the doctor with diabetic eye disease, or they know they have diabetes but do not come to the eye doctor until they have eye problems. This is also commonly referred to as “two late”, one is to find out that they have diabetes late, and the other is after they have diabetes, they know that they will suffer from DR again even later, and often come to the doctor only when they are about to lose sight of their eyes. The rate of blindness in patients with diabetic eye disease is 25 times higher than that of normal people, and the most important cause of double vision in the world today is diabetic eye disease. Therefore, special attention should be paid to prevent the occurrence of DR. 4, treatment of DR Once patients are diagnosed with diabetes, they should regularly visit the ophthalmology department for fundus examination. When the naked eye or corrected vision is normal, the fundus can be checked once every six months, when there is visual impairment, the examination and treatment should be carried out under the guidance of the doctor. (1) First of all, blood sugar should be controlled well, and blood sugar should not be made high or low, and blood sugar-lowering drugs should be used correctly under the guidance of endocrinologist. 2）When the patient has no visual impairment or a mild decrease in vision, medications to improve retinal blood circulation should be taken under the guidance of an ophthalmologist. 3) When cotton wool-like spots appear in the fundus or neovascularization has been detected, then fundus laser treatment should be performed. The purpose of laser treatment is not to improve visual acuity, but mainly to prevent further development of retinopathy in order to maintain the patient’s existing useful visual acuity and reduce the blindness rate of diabetic retinopathy. (4) When vitreous hemorrhage is present, treatment with drugs to stop the bleeding and promote the absorption of the hemorrhage can be used first; for those whose accumulated blood cannot be absorbed continuously, vitrectomy treatment is feasible and whole retina laser treatment is given, and vision is expected to be improved. (5) In addition, for macular edema and neovascularization preferable anti-VEGF intraocular drug injection, and then retinal laser treatment. 5.Prevention of DR Prevention is the most important part of diabetic retinopathy. From the beginning of diabetes, the fundus should be checked regularly, at least once a year, in order to detect the lesion and treat it early. 1) Prevention before the disease a) Regular eye examinations. When diabetes is diagnosed, you should start to go to the ophthalmology department of the hospital to do a comprehensive examination with the help of fundoscope, three-sided mirror, fluorescence imaging and other instruments, and then review once a year; for those who have retinopathy, you should review once every 3 months or make an appointment to review at any time. For diabetic patients with long duration of disease, regardless of whether there is vision loss, the fundus should be examined, which is the best way to detect this disease at an early stage. b) Patients with diabetes who have hypertension should pay special attention to actively control their blood pressure in a safe range. Hypertension can aggravate fundus vasculopathy and has the potential to significantly increase the likelihood of fundus hemorrhage. Patients should keep their blood pressure under 140/90 mmHg. c0 Maintain a good mental state and give up bad habits, such as smoking and drinking alcohol. 2) Prevention of both disease and change Diabetic retinopathy, once the diagnosis is established, should be treated aggressively. In addition to the above basic treatment, fluorescence imaging to determine whether laser treatment should be performed, and with the Chinese medicine evidence-based treatment, so that the disease can be effectively controlled and prevent other complications. In case of vitreous hemorrhage or retinal detachment, only vitrectomy combined with laser treatment should be performed. When the laser is done adequately, the vision can be maintained. (a) Chinese medicine treatment: according to the patient and the eye disease using the theory of Chinese medicine to identify and treat, using Chinese medicine to benefit the qi and nourish the yin, invigorate the blood and resolve the stagnation. (b) Laser treatment, when appropriate, can be used to protect the patient’s vision. c) Intravitreal drug treatment, due to the occurrence of iris/retinal neovascularization, or macular edema, intravitreal ani-VEGF treatment of the eye is needed to save vision as much as possible for laser or surgical treatment. d) Surgical treatment, when intraocular vitreous hemorrhage and retinal detachment are involved, vitrectomy is required to remove the intraocular blood and release and reset the retina that has been pulled.