Red lesion identification at its early stage is very essential for the treatment of diabetic retinopathy to prevent loss of vision. This work proposes a red lesion detection algorithm that uses Hexagonal pattern-based features with two-level segmentation that can detect hemorrhage and microaneurysms in the fundus image. The proposed scheme initially pre-processes the fundus image followed by a two-level segmentation. The level 1 segmentation eliminates the background whereas the level 2 segmentation eliminates the blood vessels that introduce more false positives. A hexagonal pattern-based feature is extracted from the red lesion candidates which can highly differentiate the lesion from non-lesion regions. The hexagonal pattern features are then trained using the recurrent neural network and are classified to eliminate the false negatives. For the evaluation of the proposed red lesion algorithm, the datasets namely ROC challenge, e-ophtha, DiaretDB1, and Messidor are used with the metrics such as Accuracy, Recall, Precision, F1 score, Specificity, and AUC. The scheme provides an average Accuracy, Recall (Sensitivity), Precision, F1 score, Specificity, and AUC of 95.48 % , 84.54 % , 97.3 % , 90.47 % , 86.81 % and 93.43 % respectively.