Blockbuster weight loss drugs such as Ozempic and Wegovy have gained much popularity since 2021, when the FDA approved semaglutide for weight loss.
Semaglutide, the active ingredient for Ozempic and Wegovy, has been on the market for over 20 years. Ozempic was approved for type-2 diabetes but used off-label for weight loss. Wegovy was approved for weight loss as an obesity treatment. These medications are like identical twins but with different names.
Semaglutide belongs to a class of medication called Glucagon-like peptide-1 receptor agonists (GLP-1 RAs or simply GLP-1s). To understand how these drugs work, it’s necessary to know GLP-1 RAs mimic the action of the naturally occurring hormone GLP-1 in the body, binding to GLP-1 receptors in various tissues. These drugs work by stimulating insulin secretion, suppressing glucagon release, slowing gastric emptying, and increasing satiety. They are like volume control that turn down your food noise so you can stop thinking those intrusive food thoughts. In short, drugs like Ozempic and Wegovy decrease your appetite and make you feel full faster, so you eat less and lose weight.
As a result, GLP-1 RAs help regulate blood glucose levels and promote weight loss. Compared to traditional diabetes management and weight management regimens that people take daily, these drugs can be conveniently injected once weekly to achieve significant outcomes.
Recent concerns about vision loss
A new study published in JAMA Ophthalmology suggests an association with an increased risk of sudden vision loss in patients prescribed Semaglutide. This is caused by a rare condition called nonarteritic anterior ischemic optic neuropathy (NAION).
There have been some reports that people experience blurry vision when started on semaglutide.
In this article, you will learn more about whether or not you are at risk for such serious side effects and how to minimize your risks if you are on semaglutide.
Understanding the link between Semaglutide and vision loss
A new study from Mass Eye and Ear and Harvard found patients using semaglutide (Ozempic/Wegovy) for diabetes or weight loss had a higher risk of developing NAION, a potentially irreversible blinding eye condition. “It is, in effect, a stroke of the optic nerve,” said senior study author Dr. Joseph Rizzo, the director of neuro-ophthalmology at Mass Eye and Ear in Boston.
According to the study, diabetic patients on semaglutide were four times more likely to develop NAION, while overweight/obese patients were seven times more likely.
The study was initiated due to a series of close incidents of non-arteritic anterior ischemic optic neuropathy (NAION). All three newly diagnosed cases were using semaglutide.
Although the data from the study shows significantly increased risk in semaglutide users, the researcher emphasized further researches are needed to determine if vision loss is caused by semaglutide.
Meanwhile, another new study shed light on the long-term use of semaglutide and a more common vision condition called diabetic retinopathy (DR), a condition where high blood sugar damages the blood vessels in the back of the eyes and causes eye problems. More than 80% of people who have had diabetes 20 years or longer develop diabetic retinopathy. The researcher found semaglutide use was not associated with an increased risk of progression of DR.
Semaglutide is not definitely linked to vision loss at this time, but people with diabetes and/or poor metabolic health are more susceptible to having vision problems down the line.
Risk factors for severe eye side effects while on Semaglutide
“This is information we did not have before and it should be included in discussions between patients and their doctors, especially if patients have other known optic nerve problems like glaucoma or if there is preexisting significant visual loss from other causes.” Dr. Rizzo said.
Let’s dive into some of the risk factors for people on semaglutide.
Pre-existing eye conditions
Before starting semaglutide for weight loss, it is essential to discuss any of these pre-existing eye conditions with your doctors:
Other risk factors for developing vision issues
Semaglutide is likely to decrease the chance of following risk factors except for poor nutrition, ethnicity, aging, and pregnancy.
- High blood sugar – can damage those tiny blood vessels in your eyes, resulting in poor vision health
- High blood pressure – can also damage blood vessels in the eyes
- High cholesterol – is associated with increased intraocular pressure (IOP) in the eyes
- Obesity
- Poor nutrition – balanced nutrition is essential to eye health, lack of proper nutrition can cause vision problems
- Ethnicity – Non-white ethnicities have a higher risk of developing diabetes
- Pregnancy
- Advanced age
Steps to Minimize Risk
Regular eye examinations of vision loss linked to Semaglutide
Regular eye check-ups are crucial for anyone using semaglutide drugs like Ozempic or Wegovy. These examinations can detect early signs of eye problems before they become serious.
- Baseline exams before starting treatment
Before beginning semaglutide therapy, it’s essential to have a comprehensive eye exam. This establishes your baseline eye health and helps detect any pre-existing conditions that might increase your risk.
- Frequency of follow-up exams
Once you’ve started treatment, schedule regular follow-up exams. For most patients, annual check-ups are sufficient. However, if you have additional risk factors like diabetes or a history of eye problems, your doctor may recommend more frequent visits, possibly every 6 months.
Monitoring and reporting symptoms
Being vigilant about changes in your vision is crucial. Early detection and treatment can prevent or minimize vision loss.
Common early warning signs
Be alert for symptoms such as:
- Blurred or distorted vision
- Sudden increase in floaters (dark spots in your vision)
- Partial or complete loss of vision in one or both eyes
- Eye pain or redness
- Difficulty seeing at night or in low light
When to seek medical attention
If you experience any of these symptoms, don’t wait for your next scheduled appointment. Contact your eye care professional or healthcare provider immediately. Sudden vision changes should always be treated as a medical emergency.
Maintaining overall eye health
In addition to regular check-ups, there are steps you can take to support your overall eye health:
Diet and nutrition for eye health
- Eat a balanced diet rich in vitamins A, C, and E
- Include foods high in omega-3 fatty acids, such as fish
- Consume plenty of leafy green vegetables
- Stay hydrated by drinking adequate water throughout the day
People experience different side effects from semaglutides or other GLP-1 drugs, from none to severe. If you are concerned about your nutrition or want to learn how to optimize your results while on Semaglutides, talk to a dietitian who specializes in helping people achieve long-term weight management while minimizing the side effects of Semaglutide.
Lifestyle factors
- Protect your eyes from UV radiation by wearing sunglasses when outdoors
- If you smoke, consider quitting as smoking can increase the risk of eye problems
- Maintain good blood sugar control if you have diabetes
- Keep your blood pressure under control
- Get regular exercise, which can improve overall circulation, including to your eyes
- Limit screen time and practice the 20-20-20 rule: every 20 minutes, look at something 20 feet away for 20 seconds
Discussing alternative treatments if at high risk
If you’re at high risk for vision problems, discuss your treatment options with your healthcare provider.
Reassess the benefits and risks
Your doctor can help you weigh the potential benefits of semaglutide against the risks, considering your health profile and risk factors.
Explore alternative medications
There may be other weight loss or diabetes medications that could be suitable for you with potentially lower risk to your vision. The new research mentioned at the beginning of the article was only linking semaglutide to increased risk for a rare eye problem. Your doctor can switch you to other GLP-1 receptor agonists or different classes of drugs entirely, for example, Zepbound.
Consider lifestyle modifications
In some cases, your doctor might recommend focusing more intensively on diet and exercise as an alternative or complement to medication. This is even more important if you have to stop GLP-1 medications and want to maintain your weight loss. Talk to a dietitian who is skilled in weight management.
Adjust dosage or treatment schedule
If continuing with semaglutide is deemed the best option, your doctor might suggest adjusting your dosage or treatment schedule to minimize risk.
Implement additional monitoring
For high-risk patients who continue semaglutide treatment, your healthcare team might recommend more frequent eye exams or additional tests to closely monitor your eye health.
The bottom line
Frontline doctors and researchers remain vigilant to the newly approved weight loss blockbuster drugs, such as Ozempic and Wegovy. GLP-1 RAs drugs have shown benefits in controlling chronic risk factors such as lowering blood sugar and helping people lose weight. Although new evidence surfaced to caution us about the possible association between semaglutides and severe eye conditions, we need more time and future research to test this theory
The benefits of semaglutide may still outweigh the risks for many people.
In the meantime, here’s what we can do to help minimize the risk of severe eye problems:
- Have a comprehensive eye exam before starting GLP-1s (especially Ozempic and Wegovy)
- Schedule regular follow-up eye exams
- Be vigilant about any vision changes and seek immediate medical attention if they occur
- Maintain overall eye health through diet and lifestyle choices
- Discuss your risk factors and treatment options with your healthcare provider
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