Retinopathy in young people with diabetes is uncommon before puberty. It does, however, appear during the adolescent years. Although the specific mechanisms that trigger the development of this complication are poorly understood, recent evidence suggests that hyperglycemia as reflected by elevated glycosylated hemoglobin is associated with the development and progression of diabetic retinopathy. Because the management of these patients relies heavily upon the compliance of the patient, education as to the nature, treatment and sequelae of diabetes and its complications are essential parts of the medical management of these patients.