Diabetic Retinopathy (DR) is one of the most common causes of legal blindness in developing countries, particularly between the ages of 20 to 65 years. Kiribati is currently facing the burden of DR where more than 5% of diabetes patients had experienced negative impacts of DR. This study aimed to explore the perceptions of DR patients on DR management in South Tarawa, Kiribati. This qualitative study was carried out at the Eye clinic in Tarawa Central Hospital from the 29th of August to 23rd of September, 2022. Patients diagnosed with DR of both sexes aged ≥ 18 years were purposively selected to participate in this study. 27 DR patients were recruited and interviewed using a semi-structured open-ended questionnaire. Manual thematic analysis was applied to observe the similarities and differences in answers obtained from interview transcripts. A total of 27 DR patients were enrolled in this study. The majority of patients were between the age of 50–59 (37%) and were males (62%). The findings highlighted a lack of knowledge and awareness of DR management among patients with diabetes in Kiribati. Poor health education, in-availability and lack of access to eye care services, patient belief, and healthcare system issues were identified as the most crucial contributing barriers. These data characterized the need for more communication campaigns including specific messaging on DR and its management to increase diabetes patients’ awareness of the importance of DR treatments.