The effective and efficient evaluation and triage of patients at risk for vision loss from diabetic eye disease remains a critical health care challenge. The global epidemic of diabetes mellitus will put more than 590 million individuals at risk for vision-threatening complications of diabetic retinopathy (DR) over the next few decades. Advances in treatment have greatly improved visual outcomes for many patients with diabetes mellitus. Nonetheless, optimal results from these therapies cannot be obtained unless individuals with vision-threatening diabetic pathology are identified early enough to be treated in an appropriate and timely fashion. Telemedicine programs for DR have the potential to address this issue by lowering barriers to screening and allowing access to a large population of patients with diabetes mellitus who would not otherwise be evaluated through traditional means.1