This study was performed to evaluate a healthcare strategy based on teleophthalmology for diagnosis and management of primary healthcare users. A descriptive cross-sectional study was conducted to review the medical records of patients from January 2013 to December 2014 from primary care units in the city of Sã o Paulo. The units referred patients, who had diabetes or high blood pressure, and were users of chloroquine compounds, for a fundus examination. The images were sent to a reading center for review, diagnosis, and patient referrals. From 9173 analyzed patients, 570 (6. 2%) were excluded because of poor image quality. Of the remaining patients, 4933 (57. 3%) had diabetes, 7242 (84, 2%) systemic hypertension, and 113 (1. 3%) used chloroquine. Of these, 989 (11. 5%) patients needed ophthalmologic treatment. The most frequently prescribed treatments were cataract extraction in 692 (70%) of 989 and photocoagulation in 245 (24. 8%) of 989 cases. Overall, cataract extraction was indicated in 692 (8%) of 8603 cases and photocoagulation in 245 (2. 8%) of 8603 cases. When only patients with diabetes were considered, the indication for photocoagulation increased to 4. 5%. The results showed that non-medical professionals could produce good-quality ocular images for screening of ocular diseases in most cases; only 6. 2% of ocular images did not meet quality requirements. Most patients referred for fundus examination did not need a specific treatment, indicating that this system could be an inexpensive and reliable tool for use in developing countries.