This article explains why AI in diabetic retinopathy screening should be judged by its ability to improve the full care pathway, not only by algorithm accuracy. It highlights how AI-assisted screening can support referral uptake, faster communication, coordinated follow-up, and safer screening-to-treatment pathways for people with diabetes. The article positions diabetic retinopathy AI as a health-system redesign tool for ophthalmology, diabetes care, public health, and digital health governance.

This flagship reference publication examines age-related macular degeneration as a growing clinical, public-health, ageing-society, and health-system challenge. It connects population ageing, retinal disease burden, treatment sustainability, geographic atrophy innovation, artificial intelligence, workforce capacity, and lifelong vision care. The article introduces Dr. Samer Al-Diri’s Sustainable Vision Care Framework for retina specialists, policymakers, healthcare executives, public-health leaders, and AI-health stakeholders.