The Scottish Medicines Consortium has given the green light for doctors to use Lucentis (ranibizumab) on patients with diabetic macular oedema.
Trials showed the drug led to "significant" improvements in vision.
Glasgow has the highest incidence of diabetes in Scotland, with around 56,712 patients registered, followed by Lanarkshire at 28,629.
NHS Greater Glasgow and Clyde said it was working with the clinicians to assess the implications of intro-ducing the drug into ophthalmology services.
Currently the only treatment is laser therapy which can only stabilise the condition and can cause damage to eye tissue.
Around 4000 people in Scotland are estimated to have diabetic macular oedema and it is the leading cause of blind-ness among the working age population.
The macula is the central part of the retina responsible for colour vision and perception of fine detail.
DMO occurs as a result of changes in retinal blood vessels in people with diabetes.
It is more likely to happen if diabetes is poorly controlled and the blood contains too much glucose.
Ranibizumab which is given by injection into the eye, costs £742 per injection and must be given monthly until vision is improved.
Estimates suggest sight loss costs the NHS and the public sector in Scotland around £194million a year and millions more in broader terms.
The drug has not been recommended for widespread use in England by healthcare guidance body NICE, on cost grounds, however, a final decision is not due until February.
Jill Daley, a radio presenter from Glasgow, lost her sight, virtually over two weeks, after developing diabetic retinopathy which is similar to DMO. Jill, 35, of Dowanhill, said: "The only symptom I had was a black dot in my eye that wouldn't go away. I didn't think anything of it.
"I went to the doctor and he sent me to hospital. I was given laser therapy but I wasn't panicking.
"Two weeks later I was completely blind. My mum came into my room and I asked her to turn the light on. It was broad daylight. I'd had it for quite some time but didn't know.
"In those days, they didn't have the screen-ing programme."
Jill had four nine-hour operations to try to correct her sight but to no avail. She said: "In the end I said, let's stop chasing rainbows."
The decision by the Consortium has been welcomed by the Royal National Institute for the Blind.
RNIB Scotland director John Legg said: "Ranibizumab is a treatment which offers real hope for some patients, many of whom may otherwise lose their sight completely."
A spokeswoman for NHSGGC said it would work with clinicians and managers to assess resource requirements for the treatment.