The International Diabetes Federation estimates that 642 million people worldwide will have diabetes by 2040.1 Diabetic retinopathy (DR) is a leading cause of acquired vision loss among the working adults worldwide, accounting for 37 million cases of blindness worldwide.2 Among people with diabetes, the prevalence of DR is 34.6%, with 7% having vision-threatening DR, defined as diabetic macular edema or a diabetic retinopathy severity level of severe nonproliferative diabetic retinopathy or worse.3 Of those with diabetes, DR is more prevalent in rural areas, presumably in part owing to poorer access to screening services.4