OBJECTIVE: To investigate conformance with a practice guideline in the eye care of patients with diabetes. METHODS: The care of 210 patients with diabetes seen in a multispecialty eye care setting was compared with the recommendations of the American Academy of Ophthalmology's Preferred Practice Pattern. Criteria measured included appropriate classification of stage of disease, follow-up intervals based on stage of disease, and initiation of appropriate laser treatment. RESULTS: The 210 patients whose charts were reviewed showed high levels of conformance with recommended care patterns. All patients were appropriately classified. From 91-100% of patients were seen within the recommended time intervals and received laser treatment when indicated. CONCLUSION: The American Academy of Ophthalmology's Preferred Practice Pattern can be easily operationalized into review criteria. Application of these review criteria to one multispecialty eye care setting shows evidence of high rates of conformance with recommended care.