Aim of the study; Was to know at what stage or degree of disease in people or patients with DR during the time of diagnosis, either at stage of background, non-proliferative or pre proliferative DR, proliferative DR, or diabetic maculopathy which affects the macula and central visual acuity. Broad objective; Was to determine the severity of diabetic retinopathy at the point of diagnosis at eye department of KCMC in a year 2015 from January to December. The design was selected because it could adequately address the objectives within a short period of data collection. Methodology; This was a retrospective hospital based cross sectional study that was conducted at Eye department in KCMC from January to July 2016. With the study population been the patients attended Eye clinic in 2015 from January to December. Reaults; The total of 110 DR patients were enrolled, males were 54.5% and the mean age of 59 years Proliferative DR (PDR) found to have large percent of 29.1 followed by D Maculopathy 21.8%, background 19.1%, Non Proliferative DR (NPDR) 13.6% and lastly 16.4% of patients found to have normal fundus. The level of visual impairment were Normal vision were 46.4%, 41.8% (RE, LE), Mild to Moderate were 16.4%, 8.2% (RE, LE), Severe visual impairment were 34.5%, 41.8% (RE, LE) and Blindness (Hand movements, perception of light, and no perception of light) were 2.7%, 8.2% (RE, LE). And the proportion of visual impairment due to DR versus Cataract were, DR 76.4%, Cataract 17.3%, the remaining 6.4% were due to both DR and Cataract. Conclusion; Due to the fact that results has shown large percent of patients with DM participated in this study found to be in the late stage of the disease which PDR 29.1% and D Maculopathy 21.8%, this could be due to longer duration of the disease as you can see the mean age of the participant were 59 years. Also in evaluating the degree of visual impairment many patients were in the level of Normal vision by 46.4%, 41.8% ( RE, LE), so this could be among the reason why they were coming in the late stage of DR as they still have normal vision.