Purpose. The purpose of this study was to assess optometric care of diabetic patients. The American Optometric Association recommends dilated eye examinations at least once a year for people with diabetes. Methods. Onsite chart reviews of 1497 diabetic patient charts were performed at a volunteer sample of Ohio-based optometric practices (n = 82). Four percent of all optometrists in the state of Ohio were surveyed. Data were collected from a 10-year period and included doctor age, membership in the Ohio Optometric Association (OOA) Diabetes Initiative, patient age, date of examinations, chief complaints, and dilation at examination. The primary outcome of the study was the frequency of dilated eye examination for diabetic patients by optometrists. Results. Optometrists dilated 85.8% of diabetic patients at their last comprehensive examination. The percentage of diabetic patients dilated by optometrists increased from 40.0% in 1994 to 91.5% in 2003. The average time since last comprehensive eye examination for diabetic patients was 1.0 ± 1.8 (mean ± standard deviation) years. Diabetic patients who were dilated at a comprehensive eye examination returned to care on average 0.7 years sooner than those who were not dilated. Doctor-level factors related to a higher average percentage of dilations were younger doctor age (β = -6.1 %/10 years of doctor age; 95% confidence interval [CI], -10.1 to -2.1) and membership in the OOA Diabetes Initiative (β = 11.6%; 95% CI, 2.3 to 20.8). Conclusions. There is variability in diabetic eye care by optometrists. However, the majority of optometrists surveyed in this study provided dilated eye examinations for their diabetic patients. Programs desiring to increase compliance to diabetic standard of care guidelines may benefit by targeting both doctors and patients. Copyright © 2005 American Academy of Optometry.