By Vered Hazanchuk June 23, 2023 for the American Academy of Ophthalmology.
The diabetes drug semaglutide has been making headline news since the medications Ozempic and Rybelsus received FDA approval to help people with diabetes control their blood sugar. Wegovy is a similar medication approved for obesity treatment.
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.
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.