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OBJECTIVE Diabetic retinopathy and macular edema were prevalent and a major cause of blind in developed countries. This study was performed to estimate and evaluate the rate of screening, factors associated with screening, and economic impact of diabetic retinopathy or macular edema on patients with diabetes in the United Arab Emirates (UAE). METHODS Retrospective longitudinal cohort study using the Abu Dhabi administrative claims database. A total of 34,629 new diabetic patients were identified and were followed for one-year. The screening and diagnosis rates of diabetic retinopathy and/or macular edema and treatment costs during a follow-up period were measured. The Screening was defined as having any codes related with diagnosis or treatment of diabetic retinopathy or macular edema. Total treatment costs for patients with diabetes were calculated by adding medical service costs and prescription drug costs. Diabetes-related costs were calculated by costs related to diabetes and diabetes-related comorbidities. RESULTS Of eligible patients, 21.7% were screened for diabetic retinopathy or macular edema. Screening was higher in patients aged ≥45 years, women, residents of the Northern Emirates, patients who used insulin at index diagnosis month vs. non-users, and patients with comorbidities (p<0.001). The average total annual treatment costs were significantly different between patients with and without diabetic retinopathy ($4,820 vs. $2,638) and with and without macular edema ($4,045 vs. $2,668). CONCLUSIONS The screening rate for diabetic retinopathy in the UAE was very low and was influenced by demographic, socioeconomic, and clinical characteristics. Diabetic retinopathy and macular edema substantially increased total treatment costs and diabetes-related cost.