A large Rutgers-led study has identified a possible vision risk associated with widely used diabetes and weight loss medications, including Ozempic and Wegovy. The findings, published in Annals of Internal Medicine, suggest people taking these drugs may face a slightly higher risk of a rare eye condition that can cause sudden and potentially permanent vision loss.

The drugs involved are glucagon-like peptide-1 receptor agonists: semaglutide (sold as Ozempic and Wegovy) and tirzepatide (Mounjaro and Zepbound). The condition is ischemic optic neuropathy, which occurs when blood flow to the optic nerve is reduced, and because that nerve carries visual information from the eye to the brain, damage to it can lead to significant vision problems.

Key results

Researchers analyzed a large database of US adults aged 18 to 65 with Type 2 diabetes who had recently started a medication to manage it. GLP-1 use was associated with a modest increase in the likelihood of ischemic optic neuropathy.

The size of that increase is the number worth holding onto. Lead author Chintan Dave, of Rutgers Institute for Health, Health Care Policy and Aging Research, put it at approximately three to four additional cases per 10,000 patients treated with GLP-1s over 18 months, and said that while the condition was rare, it is clinically important because it can involve sudden vision loss.

Who the cases clustered in

Most patients in the study who developed the condition were men, or men and women aged 50 to 65, Dave said. He added that early recognition of symptoms and prompt ophthalmologic evaluation may be especially important for patients at higher baseline risk.

More than 80% of ischemic optic neuropathy cases are estimated to involve the non-arteritic anterior form. Rather than causing complete blindness, it usually affects part of the vision in one eye, and patients may notice sudden blurriness, dimming, or missing areas in their field of view.

Limitations

The researchers caution that their findings do not establish that GLP-1 medications directly cause optic nerve damage. Differences in patients' underlying health conditions could help explain the increased risk observed, and the team says additional research is needed to determine whether the drugs themselves contribute.

Bottom line

This is an association in claims-style data, not a mechanism, and the absolute risk stays low. With these drugs now prescribed to people with and without Type 2 diabetes, the researchers argue continued safety monitoring matters more than the effect size alone suggests.