Diabetic retinopathy is the leading cause of new cases of legal blindness among Americans between the ages of 20 and 74. Multi-center clinical trials sponsored by the National Eye Institute have demonstrated that pan retinal photocoagulation for proliferative diabetic retinopathy and focal laser for diabetic macular edema are both effective in preventing visual loss. Unfortunately, many diabetic patients are not examined by an ophthalmologist, thereby preventing the delivery of potentially vision-saving treatment. There is data to suggest that there may be a lack of awareness on the part of primary-care physicians of the importance of regular eye examinations or the potential benefits of laser treatment for diabetic retinopathy. A randomized, multi-centered investigation will determine if an educational process will improve the ability of primary-care physicians to recognize vision-threatening diabetic retinopathy and, if so, which of the following educational strategies is most effective: 1. Independent study materials issued at 0 months 2. Independent study materials issued at 0 months and slide-script program at 0 months. 3. Independent study materials issued at 0 months and direct ophthalmoscopy on model eyes at 0 months. 4. Independent study materials issued at 0 months, slide-script program at 0 months and direct ophthalmoscopy on model eyes at 0 months. 5. Independent study materials, slide-script program and direct ophthalmoscopy on model eyes at 0 and 6 months.
