PURPOSE: To identify the reasons why diabetic patients do not undergo periodic examination. DESIGN: Cohort study. METHODS: A questionnaire survey of 1,333 Japanese type 2 diabetic patients was conducted at Tokyo Women's Medical University. Performance of ocular examinations was investigated over 5 years and the reasons for not undergoing examination were analyzed. RESULTS: Periodic ocular examination was performed in 69.5% of patients, but not in 30.5%. The questionnaire survey showed that physicians usually explained the risk of ocular complications and recommended periodic examination. More than 98% of the patients were aware of diabetic eye disease. Multivariate logistic regression analysis showed the main reason for skipping examination as a reason was that patients believed they had no diabetic retinopathy. CONCLUSIONS: Patients should be informed about the necessity of receiving periodic ocular examination even if they do not yet have retinopathy.