Eye Complications. Diabetes accounts for 12,000 to 24,000 new cases of blindness annually and is the leading cause of new cases of blindness in adults ages 20 to 74. Given long duration of the disease and low control of insulin administration, nearly all type 1 diabetics will develop retinopathy -- abnormalities of the blood vessels in the retina -- at some point in their lives, although only a minority of cases cause severe vision loss or blindness.

By the seventh year retinal damage has occurred in 50% of type 1 patients, and after 14 years, more than 90% develop retinopathic changes. In nonproliferative or background retinopathy, the early and more common type of this disorder, abnormally weakened blood vessels in the retina rupture and leak, and waxy areas may form. If these processes affect the central portion of the retina, swelling may occur causing reduced or blurred vision. If the weak blood vessels become blocked and blood flow is cut off, soft, "woolly" areas may develop in the retina's nerve layer.

These areas may signal the development of proliferative retinopathy; in this more severe condition, new, abnormal blood vessels form and grow on the surface of the retina. They may spread into the cavity of the eye or bleed into the back of the eye; major hemorrhage or retinal detachment can result, possibly causing severe visual loss or blindness. Although the sensation of seeing flashing lights may indicate retinal detachment, often there are no symptoms of progressing retinopathy. People with diabetes are also at higher risk for developing cataracts and certain types of glaucoma.

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