Significance of this studyWhat is already known about this subject? ► Telemedicine has been applied in diabetic retinopathy (DR) screening. ► High rates of incomplete referral after telescreening for DR, and patients factors or healthcare system factors might contribute to the barriers for accessing the eye care services.What are the new findings?► Referral completion and perceived barriers to the referral were assessed in a large representative sample with vision-threatening DR (VTDR) from the communities after DR telescreening. ► The issue of incomplete referral is serious among the individuals with VTDR, particularly in the elder and low education level population. ► The negativity of knowledge-related and attituderelated factors might be more prominent than logistic barriers in predicting the incomplete referrals.on July 4, 2020 by guest. Protected by copyright.