Here’s What Ophthalmologists Want You to Know
The diabetes drug semaglutide has been making headline news ever since the medication received FDA approval to help with blood sugar control and obesity treatment. Semaglutide medications include Ozempic, Wegovy, and Rybelsus.
Results of the Ozempic studies show semaglutide can significantly help people control their blood sugar. But the studies also showed it can cause vision changes, including blurred vision, worsening of diabetic retinopathy and macular complications. So, do the benefits outweigh the risks?
What Is Semaglutide and How Does It Affect the Eyes?
Semaglutide helps people lose weight and control their blood sugar by releasing the hormone that makes us feel full while eating. This hormone, called GLP-1, also prompts the body to create more insulin, which reduces blood sugar.
When the body experiences a change in sugar level, it can affect the shape of the eye’s lens. This change is what causes blurry vision, a side effect of semaglutide.
Older patients are more likely to experience blurred vision when beginning the medication, said retina specialist Raj Maturi, MD. This is because the eye’s lens becomes less flexible as we age, so vision takes longer to stabilize when the body experiences these changes in blood sugar levels.
“The good news is that this is a temporary side effect, usually subsiding after three or four months,” said Dr. Maturi.
Can Semaglutides Cause Blindness?
One new study suggests there may be a connection between semaglutide use and increased risk for a blinding eye disease called non-arteritic anterior ischemic optic neuropathy (NAION). But experts say there isn’t enough data yet to suggest patients should be concerned or should stop taking their medications. People who have diabetes are already at risk for NAION, whether they use semaglutide or not.
“It is premature to conclude that the association is a causal association. More research is necessary to test the hypothesis. Until then, patients should be aware of this information and, in consultation with their care team, make a careful, informed choice based on their individual risk profile,” said neuro-ophthalmologist Andrew Lee, MD.
If patients are already taking semaglutide and have not experienced any symptoms, they should continue to do so as instructed and discuss any questions or concerns with their primary care physician. People interested in starting to take semaglutide for blood sugar control or for weight loss should ask their physician if this medication is right for them.
Will Ozempic and Other Semaglutides Make Diabetic Retinopathy Worse?
People with diabetes sometimes experience abnormally high blood sugar levels, which can cause blood vessels in the eye to leak. This is what causes diabetic eye disease, a leading cause of vision loss.
“It may seem strange that a drug made to help control diabetes could make your eyesight worse, but it’s something we’ve known about for a while. A large clinical study suggested that there is an association between blood sugar control and worsening of diabetic retinopathy,” said Dr. Maturi. “For the majority of people, this won’t be a problem and symptoms are manageable. Make sure to let your ophthalmologist know of any medications you are using, and get your eyes checked regularly. He or she will track for any vision changes and recommend potential treatments.”
Should I Use Ozempic for Weight Loss?
A primary care physician can help patients decide if Ozempic or other dieting medications are right for them. While semaglutide can help avoid overeating, ophthalmologists emphasize that this is not a substitution for taking care of your overall health.
“You still need to live a healthy lifestyle—eat well, exercise, and show up to your medical appointments as advised. For patients who really struggle with their diet and controlling their blood sugar, this drug can powerfully influence the desire to eat and help improve their life,” said Dr. Maturi. “My suggestion for a patient who discussed this with their doctor and decides to use the drug is to make sure that they are using it as instructed and to be patient with any known side effects, including blurry vision.”
Researchers are working to learn more about the long-term effects of semaglutide on diabetic retinopathy in people with type 2 diabetes. A study known as FOCUS will evaluate the effects of semaglutide in addition to diabetes medication on diabetic retinopathy. The study is expected to conclude in February 2027.
Thank you to Vered Hazanchuk for the original post on AAO.org
Reviewed By Raj K Maturi, MD
Published Jul. 11, 2024
Last Reviewed on Jul. 08, 2024