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Retinopathies are divided into two broad categories, simple or nonproliferative retinopathies and proliferative retinopathies. As diabetes progresses, the blood vessels that feed the retina become damaged in different ways. The damaged vessels can have bulges in their walls (aneurysms), they can leak blood into the surrounding jelly-like material (vitreous) that fills the inside of the eyeball, they can become completely closed, or new vessels can begin to grow where there would not normally be any: although these new blood vessels are growing in the eye, they cannot nourish the retina and they bleed easily, releasing blood into the inner region of the eyeball, which can cause dark spots and cloudy vision. Once symptoms are noticed, they include poorer than normal vision, fluctuating or distorted vision, cloudy vision, dark spots, episodes of temporary blindness, or permanent blindness. Unfortunately these new blood vessels are very fragile and usually rupture, permitting bleeding to occur within the eye. The symptoms can occur hours to days after the incident. For example, doses of 20-40mg per day of tamoxifen usually does not cause a problem, but much higher doses may cause irreversible damage.
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