We read with interest the article by Wong et al,¹ which studied a non-diabetic population consisting of 7992 people aged 49–73 years. Non-mydriatic retinal photographs of one eye were taken and graded for retinopathy lesions using standardised protocols. Surprisingly, the presence of typical retinopathy lesions (microaneurysms or retinal haemorrhages) in people without diabetes did not significantly predict subsequent development of diabetes over a period of 3.5 years. Incident diabetes developed in 4.7% and 3.6% of people with and …