New Study Links Weight Loss Drugs to Eye Condition Risks

SALT LAKE CITY, Utah — A recent study published in JAMA Ophthalmology suggests a potential connection between glucagon-like peptide-1 (GLP-1) medications, such as semaglutide and tirzepatide, and serious eye conditions, including a rare disorder known as nonarteritic anterior ischemic optic neuropathy (NAION). The research is particularly crucial as the use of these drugs for weight loss and diabetes management has surged in recent years.

The study examined nine patients with an average age of 58, all taking semaglutide or tirzepatide. Of these patients, seven developed NAION, which can lead to irreversible vision loss. Dr. Bradley Katz, the study’s lead author and an ophthalmologist at the John A. Moran Eye Center, emphasized the importance of continued research to determine how these medications may impact overall health.

“Between 2-3% of the U.S. population received a prescription for one of these medications in 2023,” Katz said. “Because so many people are using these medications, it’s critical to monitor any ill effects on the eye or other parts of the body.”

According to Katz, the nine patients in the study experienced varying degrees of vision complications. Specifically, one participant suffered a stroke in the retina, which resulted in irreversible loss of vision in one eye. Another patient developed swelling in both optic nerves but did not lose vision.

While the precise cause of these vision issues remains uncertain, researchers speculate that rapid fluctuations in blood sugar levels might contribute. “These drugs are very effective at reducing blood sugar, and when one rapidly reduces blood sugar, it can cause swelling in the optic nerve,” Katz explained.

He further clarified that they do not recommend discontinuing GLP-1 medications for those who have been prescribed them. “What we are recommending is that if you experience a change in your vision while using one of these drugs, you should consult the prescribing doctor and see an ophthalmologist.”

Dr. Mir Ali, a board-certified general and bariatric surgeon based in California, commented on the study’s findings, calling them a “rare and unusual complication.” He noted that although millions have used GLP-1 medications for years, it is difficult to determine an exact mechanism for why these complications arise.

Ali stressed the need for patients to remain vigilant. “If a patient notices a significant change in vision, or any other system, they should contact their prescribing provider,” he said. “It is important for people to be aware of all potential side effects and complications.”

Similarly, Dr. Howard Krauss, a surgical neuro-ophthalmologist, recommended that patients undergo eye exams at least once a year, particularly those with risk factors for ocular issues. “The proposed mechanisms of injury put forward by the authors are worthy of investigation,” Krauss said.

Katz and his colleagues are urging the FDA to mandate post-marketing surveys for GLP-1 medications to assess the true incidence of eye complications associated with these drugs. They are also collaborating with other health professionals across the United States to pursue comprehensive reviews of the medications and their potential ocular side effects.