Diabetic retinopathy (DR) is the leading cause of blindness among the working-age population, affecting approximately one-third of diabetes patients globally. As the country with the world's largest diabetic population, China faces a severe situation in DR prevention and control due to the vast number of people affected. Early screening and timely intervention have been proven effective in slowing disease progression and significantly reducing the risk of vision loss. However, constrained by multiple barriers such as uneven distribution of medical resources, insufficient primary-level screening capacity, low patient awareness, and inadequate health insurance coverage, China's current DR screening rate remains below 10%, significantly lower than that of developed countries. To address these challenges, various regions in China are actively exploring innovative screening models utilizing artificial intelligence technology, with some preliminary successes in practice. Concurrently, the "14th Five-Year Plan" for National Eye Health explicitly calls for enhancing primary care screening capabilities and implementing a tiered diagnosis and treatment system, providing policy support for DR screening efforts. Nevertheless, issues such as the limited coverage of primary-level screening and insufficient standardization in technology application remain prominent. Future efforts should further strengthen primary-level capacity building, promote multidisciplinary collaboration, standardize technical procedures, and improve policy support. This comprehensive approach aims to achieve broad coverage of DR prevention and treatment, effectively reduce blindness rates, and ultimately enhance the overall level of national eye health.

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