Let me ask you guys about this. As a PA and now starting MS3, I have always sent my diabetic patients for routine ophthalmological exams but recently I have seen some of them coming back with notes from these therapeutic optometrists, even after I specifically make the referral to the ophtho. I am a little concernec about it. In fact, my wife being a type I for 6 years now, she just went to one of my professors who is an ophtho and she too came back home having seen the theapeutic optometrist. Has this become a standard of acceptance and should I just go with the flow, or does the ADA really want ophtho's themselves to be doing these exams? I don't really know the complexity involved in looking for diabetic retinopathy but I think this is sort of heading in one of those anesthesiology/CRNA directions. I just wonder what you future and current ophtho's think.