Diabetes mellitus is an important public health problem worldwide, and more than 75% of patients who have had diabetes mellitus for more than 20 years will have some sort of retinopathy. Diabetic retinopathy correlates with the duration of diabetes; thus with increasing life expectancy, diabetic retinopathy and the ensuing blindness will tend to increase. In view of the increasing prevalence of diabetes mellitus and diabetic retinopathy throughout most of the world, a consultation on prevention of blindness from diabetes mellitus was convened by the World Health Organization to review the current status of diabetic retinopathy care and to define approaches to screening, early detection and management in populations in different settings. This publication reports on the findings of the consultation and provides recommendations and guidelines for the prevention and care of blindness from diabetes mellitus.