With the rapid development of social and economic level, people’s lifestyle and diet have changed dramatically, and the prevalence of diabetes has increased. The Chinese Medical Association Diabetes Branch has conducted a retrospective analysis of the status of diabetic complications, and the results showed that about 1/3 of the cases were combined with hypertension, cardiovascular disease, eye and kidney disease, and more than half of the cases were neuropathy. Diabetic retinopathy is one of the common serious complications of diabetes and an important cause of blindness in adults. Diabetic retinopathy can be roughly divided into two types, non-proliferative diabetic retinopathy and proliferative diabetic retinopathy. Many diabetic patients often ignore their own eye conditions and do not go to the hospital until they can’t see anything and almost lose their vision, which is often at an advanced stage of proliferative diabetic retinopathy. This not only delays the disease and misses the best time for prevention and treatment, but also makes the treatment of advanced diabetic retinopathy less effective and increases the financial burden of diabetic patients. Here we briefly introduce the early prevention and treatment of diabetic retinopathy. 1, the danger of diabetic retinopathy Diabetic eye disease is one of the microvascular complications of diabetes, the most common complications are retinopathy, cataract, glaucoma, etc., which eventually lead to blindness. The prevalence of diabetic retinopathy among diabetic patients in China is as high as 51.3%. Diabetic retinopathy occurs due to abnormalities in glucose metabolism in the body, resulting in microangiopathy in various tissues and organs throughout the body. Reflected in the fundus, a series of fundus changes occur: hemorrhage, exudation, neovascularization in the retina, edema in the macula, vitreous hemorrhage, and finally detachment of the retina due to proliferative membrane traction. If a large number of vitreous hemorrhages or retinal detachments occur, vision will be seriously affected. Patients with early diabetic retinopathy often have no specific discomfort, and the condition gradually worsens without the patient being aware of it. For diabetic patients, regular fundus examination and early diagnosis and treatment are the most effective means to control the development of diabetic retinopathy. The incidence of diabetic retinopathy is closely related to the duration of diabetes, the control of blood sugar and the level of glycated hemoglobin. The American Epidemiological Survey reports that the incidence of diabetic retinopathy is 7% in people with less than 10 years of diabetes, 26% in people with 10 to 14 years of diabetes, 63% in people with more than 15 years of diabetes, and 95% in people with more than 30 years of diabetes. That is, the incidence of diabetic retinopathy increases with the duration of diabetes. In addition, many scholars at home and abroad have reached a consensus that glycemic control in the normal range can prevent and delay the development of systemic microangiopathy and ocular complications. The incidence of diabetic retinopathy is 3.2 times higher in diabetic patients with glycosylated hemoglobin levels above 12 than in those below 12. In general, diabetic patients with uncontrolled blood glucose in the normal range, fluctuating blood glucose levels, and long duration of disease are more likely to develop diabetic retinopathy. For such people, active prevention and timely treatment are essential to control the occurrence and development of diabetic retinopathy. 3.What are the specific manifestations of diabetic retinopathy In the early stage of diabetic retinopathy, patients have almost no obvious visual symptoms, but with the development of the disease there will be varying degrees of visual impairment, when the lesion involves the macula area, vision loss, visual distortion, and dark spots in the visual field will occur; when the small blood vessels in the retina rupture, a small amount of bleeding into the vitreous cavity, patients will suddenly feel Once a larger blood vessel ruptures and a large amount of blood gushes into the vitreous cavity, the patient will experience a sudden loss of vision and lose sight of things. If the retinal vessels are occluded, severe ischemia and hypoxia occur, and the lesion progresses to proliferative diabetic retinopathy, serious complications such as retinal detachment can occur. Some advanced patients also develop neovascular glaucoma, which manifests as increased intraocular pressure, headache, eye pain, nausea and vomiting. Severe late stage patients may suffer from eye atrophy or even need to have their eyes removed. 4, how to prevent diabetic retinopathy First of all, reasonable and correct living habits and dietary guidance is the basis of blood sugar control. Diabetic patients should actively correct the bad living and eating habits. For example, quit smoking and alcohol; adhere to a light diet, reduce the intake of high-fat, high-calorie and high-sodium-salt food; strengthen physical exercise, etc., which are the basis for controlling blood sugar as well as reducing and slowing down the occurrence of eye complications. Second, a good medication regimen is an important guarantee to stop the progression of diabetes. Patients with diabetes should seek medical attention in a timely manner and use medication according to the needs of their condition in a regular and rational manner, in order to prevent and slow down the development of diabetic retinopathy by controlling blood sugar within the normal range and reducing blood sugar fluctuations. Third, regular fundus examinations should be performed to prevent the development of diabetic retinopathy. Patients with diabetic retinopathy have no specific symptoms in the early stages, which often delays treatment. Therefore, regular regular eye examinations, such as routine fundus examinations once every 3-6 months (with special instructions to dilate the pupil), are important for early diagnosis and treatment of the disease. This will not only reduce the pain of vision loss, eye pain and headache when the patient’s condition is delayed to an advanced stage, but also avoid the need for surgery in advanced patients, thus effectively improving the quality of life of diabetic patients, reducing the medical burden of diabetic patients and alleviating the burden on families. 5.How to treat diabetic retinopathy once it is diagnosed For patients with mild diabetic retinopathy, we advocate that patients should control blood sugar, avoid fluctuations, eat a reasonable diet and take regular medication, and go to a professional hospital for regular checkups to monitor changes in the fundus of the eye. When the lesion develops further, once proliferative lesions or pre-proliferative lesions are found, patients should actively undergo retinal laser treatment according to the guidance of a professional ophthalmologist to prevent a series of complications such as further neovascularization and to preserve a certain level of vision. Laser is an effective treatment for proliferative diabetic retinopathy. Laser treatment improves retinal hypoxia, prevents the development of fragile neovascularization, and promotes the regression of neovascularization, thus greatly reducing the risk of hemorrhage. Total retinal laser photocoagulation significantly reduces the risk of severe vision loss due to diabetic retinopathy, effectively halts disease progression, and prevents the disease from progressing to an advanced stage where surgery is necessary. If patients can receive effective laser treatment at an early stage in a regular hospital, their vision prognosis is often more favorable. Long-term clinical experience tells us that the prognosis of actively using laser to prevent disease progression is far better than the effect of later surgical treatment. When the disease progresses to a more serious stage, diabetic retinopathy causing vitreous hemorrhage; progressive fibrous proliferation, macular shift due to fibrous proliferative membrane in the posterior pole and proliferative mechanized traction, macular edema, retinal detachment, diabetic neovascular glaucoma, etc., the necessary surgical treatment is needed at this time. Vitrectomy is the primary route of treatment for advanced diabetic retinopathy, and depending on the severity and characteristics of the condition, a series of related surgical treatments such as inert gas or silicone oil filling and vitreous cavity injection may also be required. It has been found that systematic and scientific surgical treatment can restore varying degrees of vision for patients, and the course of the disease is interrupted and stabilized. An increasing number of experts advocate early surgery, i.e., bleeding for 1 to 4 months before more serious complications such as macular detachment occur. Early surgery has a success rate of 85%, with the vast majority of patients retaining 0.05 or more vision. If surgery is delayed until the end stage of the disease, the postoperative outcome is less than ideal. In conclusion, diabetic retinopathy is not a scary disease, but rather a disease that is neglected and misses the best time for treatment. For the majority of diabetic patients, stable control to achieve normal blood sugar levels, regular scientific eye examinations, active and reasonable laser and surgical treatment can help patients save their vision, improve their quality of life and reduce unnecessary financial burdens. We hope that the whole society can actively pay attention to the eye health of diabetic patients, leaving more light, more health and happiness for tomorrow.