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February 9, 2025
A recent study published in JAMA Ophthalmology has raised concerns about potential vision problems in a small percentage of patients using the popular GLP-1 receptor agonist medications semaglutide (brand names Wegovy and Ozempic) and tirzepatide (brand names Mounjaro and Zepbound). However, researchers emphasize that a direct causal link between the drugs and vision loss has not been established.
The retrospective study, published online on January 30, focused on nine patients who experienced vision issues while using these medications. Some of the affected individuals were diagnosed with nonarteritic anterior ischemic optic neuropathy (NAION), a condition resulting from inadequate blood supply to the optic nerve, leading to sudden and often permanent vision impairment.
Unraveling the Link
The study was initiated after Dr. Bradley J. Katz of the John A. Moran Eye Center at University of Utah Health encountered a patient who suffered sudden, painless vision loss after starting semaglutide. The patient briefly discontinued the medication but experienced vision loss in the other eye upon resumption of treatment. Seeking further insight, Dr. Katz reached out to neuro-ophthalmology colleagues through a professional listserv, ultimately leading to the documentation of additional cases.
“We’re trying to elucidate if being on these drugs can increase your risk,” said Dr. Norah S. Lincoff, a co-author of the study and professor of neurology at the Jacobs School of Medicine and Biomedical Sciences at the University at Buffalo.
Among the nine cases, seven patients exhibited NAION-like symptoms, one developed papillitis (inflammation of the optic nerve head), and another presented with paracentral acute middle maculopathy, which can create blind spots in vision. Some patients displayed atypical symptoms, such as simultaneous NAION in both eyes—a rare occurrence.
Considerations for Patients and Physicians
While such cases remain rare, concerns have been amplified due to the rising use of these medications. A 2024 study reported that 12% of the U.S. population has used one of these drugs, with approximately 6% currently taking them.
Notably, the patients studied were in their 50s and 60s and had underlying conditions such as diabetes and cardiovascular disease—both of which can independently contribute to vision issues like diabetic retinopathy. Researchers are investigating whether the medications themselves elevate the risk or if factors like rapid blood glucose reduction play a role.
“So are these drugs increasing the risk for an episode of visual loss?” Dr. Lincoff asked. “We are still investigating. The message to primary care providers is clear: If a patient on these medications reports blurred vision or sudden vision loss, they should see an ophthalmologist immediately.”
Despite the concerns, Dr. Lincoff advises against discontinuing the medications without consulting a healthcare provider, noting that there are multiple options for diabetes and weight management.
Call for Further Research
Given the potential risks, the study authors, in collaboration with the American Academy of Ophthalmology, are recommending a post-marketing survey to better assess the prevalence of ocular complications associated with GLP-1 medications.
Disclaimer
This article is for informational purposes only and does not constitute medical advice. Patients should consult their healthcare providers before making any decisions regarding their medications.
Source: University at Buffalo
Journal Reference: Katz, B. J., et al. (2025). Ophthalmic Complications Associated With the Antidiabetic Drugs Semaglutide and Tirzepatide. JAMA Ophthalmology. doi.org/10.1001/jamaophthalmol.2024.6058.
