Half of diabetic patients do not visit an ophthalmologist as recommended, resulting in frequent and unnecessary vision loss. The NEI has set as an Healthy People 2010 objective to increase the screening rate for diabetic retinopathy. EyeTel-lmaging and the Wilmer Eye Institute are developing technology to screen diabetic patients during their visits to their primary care physician (PCP). The DigiScope, a low cost, quasi-automatic computerized fundus camera acquires digital stereoscopic fundus images and assesses visual acuity. The data are automatically transferred, via the Internet, to a reading center where expert readers, supervised by retinal specialists, identify patients with retinopathy and refer them to an ophthalmologist. The DigiScope will be provided to PCPs without capital investment on their part and a service fee will be collected from health care providers. The goals of Phase I were exceeded with the successful development of the DigiScope and the results of an independent study. In comparison with the 'gold standard', the DigiScope had a sensitivity of 98.5 percent and a specificity of 92 percent. The goals of phase II are to meet all the specifications for implementation in PCPs offices, develop the reading center and assess the impact on screening rate in different health care environments.