Key takeaways
People taking semaglutide for Type 2 diabetes may experience vision changes since diabetes can result in vision changes, and Ozempic can worsen existing problems.
Eye side effects are still considered rare on semaglutide and have only been found in a handful of studies and research.
The most common eye-related issues with Ozempic are blurred vision, diabetic retinopathy, and a condition called non-arteritic ischemic optic neuropathy (NAION).
Talk to your healthcare provider if you experience any vision changes on Ozempic. An eye exam can help them identify or rule out more serious eye conditions, and in some cases, you may be able to lower your dose to reduce your symptoms.
One of the most popular drugs for the treatment of Type 2 diabetes in 2024 is Ozempic (semaglutide). This weekly injectable drug is part of a class of medications called glucagon-like peptide 1 (GLP-1) agonists, which mimic the GLP-1 hormone your body normally produces to help you better manage your blood sugar and lose weight.
Ozempic is relatively new, but studies show it’s generally safe. The most commonly reported side effects are nausea, vomiting, loss of appetite, and abdominal pain, though some people experience other less common side effects, including vision changes and eye problems. Part of the reason this happens, says Frederick Fraunfelder, MD, University of Missouri Health Care ophthalmologist and chair of ophthalmology at the University of Missouri School of Medicine, is because Type 2 diabetes can cause vision problems, and taking Ozempic can make them worse.
Here’s what to know about how Ozempic can affect your eyes and what you should do if you notice vision changes while taking the drug.
Does Ozempic cause eye problems?
“Experiencing eye problems while taking Ozempic is rare,” says Shivesh Kumar, MD, physician and CEO of ReliantLife Weight Loss & Hormone Therapy. It’s an isolated side effect that has been reported in scientific studies but isn’t commonly seen by healthcare providers among their real-life patients. Dr. Kumar says that even the scientific reporting is limited—the studies are preliminary, and there’s no definitive link between Ozempic and eye problems.
“The Ozempic eye issues most commonly reported are blurred vision, diabetic retinopathy, macular edema, and a condition called non-arteritic ischemic optic neuropathy (NAION),” says Dr. Fraunfelder. Read more about each eye-related condition below.
Blurred vision
According to Dr. Fraunfelder, blurred vision is one of the most common eye-related side effects of Ozempic. Drugs that lower blood sugar also affect the amount of fluid in your body. “Because the lens of your eye is made mostly of water, it’s sensitive to dehydration or overhydration,” explains Dr. Fraunfelder.
When the shape of the lens changes in response to blood sugar changes, it can cause blurred vision, per the American Academy of Ophthalmology. This is usually temporary, though, lasting three or four months, and doesn’t indicate any damage to your vision.
NAION: A potential Ozempic eye condition
NAION is essentially an eye stroke, caused by the loss of blood flow to the optic nerve, resulting in sudden blurred vision, vision changes, and potentially even blindness.
According to Brigham and Women’s Hospital, experts don’t fully understand why NAION occurs, but they know that certain conditions, including diabetes and hypertension, increase your risk. Based on the results of a recent study, it’s possible that taking semaglutide also increases your risk. In this study of more than 16,000 people, those taking semaglutide were more likely to develop NAION than people taking non-GLP-1 agonists.
However, that is the only currently published study finding a link between semaglutide and NAION, and many of the study participants had one or more other risk factors for the condition, like diabetes or obesity. Dr. Fraunfelder says it’s important to know that Ozempic could raise your risk for NAION, but it’s only a possibility at this point and more research is needed.
Diabetic retinopathy
Diabetic retinopathy is a serious complication of diabetes caused by high blood sugar. It happens when the nerves of the retina are damaged and swell, close up, or grow abnormally. All of these changes can result in blurred vision, seeing floaters, and possibly losing sight completely.
While Ozempic can potentially reduce your risk of diabetes complications such as retinopathy by lowering your blood glucose levels, one large clinical trial called the SUSTAIN trial suggested that semaglutide could worsen diabetic retinopathy symptoms. However, other research—like a recent study performed at the Cleveland Clinic Cole Eye Institute—hasn’t come to the same conclusion. Some experts have suggested that the cause of worsening symptoms in the SUSTAIN trial may have been the rapid change in blood glucose levels brought on by starting semaglutide treatment rather than the drug itself.
More information is needed about semaglutide’s effects on eye health, especially in people with diabetic retinopathy. But Dr. Kumar says that if you are taking Ozempic and not experiencing any significant side effects, you should keep using it because lowering your blood sugar and losing weight are more beneficial to your eye health in the long run.
Macular edema
The macula is part of the retina. Macular edema occurs when the blood vessels of the retina leak into the macula (usually as a result of uncontrolled diabetes or as a complication of diabetic retinopathy). The macula can swell and cause blurry or distorted vision.
Like the other potential eye complications included here, more research is needed about the risk of developing macular edema while taking Ozempic. Still, a study published in 2024 found an increased risk of diabetic macular edema (DME) in people with Type 2 diabetes using semaglutide, as well as an increased risk of worsening diabetic retinopathy.
Other Ozempic side effects
Although eye side effects like retinopathy are listed as a potential complication of taking semaglutide, the most commonly reported side effects are gastrointestinal. When taking Ozempic, you may have nausea, vomiting, diarrhea, or constipation, and abdominal pain because of the delay in gastric emptying caused by the medication. Some people also have redness, itching, or swelling at the injection site.
How to manage eye problems and other Ozempic side effects
If you’re having GI distress from taking Ozempic, there are a few things you can do to mitigate some of the medication’s effects on your stomach. The manufacturer of Ozempic, Novo Nordisk, recommends staying hydrated, eating smaller meals, avoiding greasy, fatty, and sugary foods, and avoiding lying down after eating to help you manage your GI symptoms.
You can’t manage eye-related side effects of Ozempic with dietary changes, though—so what can you do? Dr. Kumar says most side effects are dose-dependent, meaning higher doses often cause more severe side effects. “Your healthcare provider may regulate your dose to mitigate your symptoms,” he explains, “keeping you on the lowest beneficial dose” (i.e., the dose that works well with the fewest side effects).
That said, if you’re experiencing any changes to your vision while taking Ozempic, contact your healthcare provider or see an ophthalmologist as soon as possible. Dr. Fraunfelder says an eye exam could help your provider distinguish between a temporary change in vision related to blood sugar changes and a more serious condition, like NAION or worsening diabetic retinopathy.
“Just don’t stop taking Ozempic cold turkey,” says Dr. Kumar, “especially not without talking to your provider first.” Given the lack of scientific research, it is difficult to attribute vision changes to semaglutide, especially in people taking the medication to treat medical conditions that also affect the eyes.
“Having diabetes—even mildly uncontrolled diabetes over many years—is far more dangerous to your eyes and your visual acuity than semaglutide would be,” Dr. Kumar says.”By and large, controlling blood sugar and your A1C levels is more important for your sight.”
Ozempic alternatives
Other GLP-1 agonists (like Trulicity, Saxenda, and Mounjaro) are approved to treat Type 2 diabetes, but since they work similarly, these medications usually carry the same potential risk of vision changes as Ozempic.
If you’re looking for other Ozempic alternatives that aren’t GLP-1 agonists, talk to your healthcare provider about oral diabetes medications like Jardiance and Glipizide, which aren’t known to have eye-related side effects. Just keep in mind that these drugs have other side effects, and may not work for you or be compatible with other coexisting medical conditions. Your healthcare provider is the best person to advise you on the Type 2 diabetes medication that’s right for you.
Sources
- American Academy of Ophthalmology and North American Neuro-Ophthalmology Society issue advice on weight loss drug and eye health, American Academy of Ophthalmology (2024)
- Can Ozempic affect eye health? Here’s what ophthalmologists want you to know, American Academy of Ophthalmology (2024)
- Eye stroke – Penn Ophthalmology, Penn Medicine
- Non-arteritic anterior ischemic optic neuropathy (NAION), Brigham and Women’s Hospital
- Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide, JAMA Ophthalmology (2024)
- Diabetic retinopathy: Causes, symptoms, treatment, American Academy of Ophthalmology (2023)
- Semaglutide and the risk of diabetic retinopathy—current perspective, Eye (2022)
- The effect of glucagon-like peptide-1 receptor agonists on diabetic retinopathy at a tertiary care center, Ophthalmology Science (2024)
- Semaglutide-eye-catching results, World Journal of Diabetes (2023)
- Macular edema, National Eye Institute (2023)
- Impact of GLP-1 agonists and SGLT-2 inhibitors on diabetic retinopathy progression: An aggregated electronic health record data study, American Journal of Ophthalmology (2024)
- Possible side effects of Ozempic® (semaglutide) injection, Novo Nordisk