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Aim: To present an analysis of a screening model for diabetic retinopathy and compare the results of screening between rural and urban populations. Methods: Between June 2003 and September 2004, 51 diabetic retinopathy screening camps (rural, 25; urban, 26) were conducted in three southern districts of India. The target population, aged 30 years and above, underwent comprehensive eye evaluation and those with referable diabetic retinopathy (proliferative diabetic retinopathy, severe non-proliferative diabetic retinopathy, severe diabetic macular oedema, or a combination of these) were referred to the base hospital for further treatment. Results: Among 7716 diabetic subjects, the age and sex adjusted prevalence of diabetic retinopathy was 18 % in the rural areas and 17 % in the urban areas. The prevalence of referable retinopathy was 6.8 % in rural areas and 4.6 % in urban areas (p,0.001). Around 63 % of individuals in rural areas and 75 % in urban areas had never previously had their eyes examined for diabetic retinopathy. Multivariate analysis revealed the following risk factors for diabetic retinopathy: age more than 50 years, known diabetes, prolonged duration of diabetes, and eyes with moderate or severe visual impairment (p,0.0001). Conclusions: The study describes a comprehensive diabetic retinopathy screening model which can identify sight threatening retinopathy and provide necessary treatment for rural and urban populations