Will Taking GLP-1’s Effect My Eyes?
Posted in Diabetic Retinopathy, Eye Blog, Medical, Mount Vernon, Sedro-Woolley, Stanwood, Whidbey
GLP-1 RAs work by mimicking a natural hormone in our body. Mimicking this natural hormone can increase insulin production, block secretion of the hormone glucagon (which helps lower blood sugar), slow stomach emptying, and increase satiety (1). Due to the more recent widespread use of GLP-1 RAs, more side effects have been noticed, including effects on the eyes.
GLP-1’s Are Popular
According to a 2025 poll, up to 18% of adults in the United States have used glucagon-like peptide-1 receptor agonist (GLP-1 RA) drugs at some point. The estimate is that 12% of adults or roughly 33.2 million people in the United States currently use GLP-1 RAs for diabetes or to help with weight loss (2). GLP-1 RAs are not new; the first FDA approval was in 2005, but in recent years use has skyrocketed due to potential weight loss benefits and help controlling Type 2 diabetes.
What Are the Effects?
The effects on eyes from GLP-1 RAs are rare, but can be significant, and are typically isolated to the retina and blood vessels in the back of the eye. There is some evidence that these medications can lead to the progression of diabetic retinopathy and macular degeneration. The exact reason why these side effects happen is not well understood, but is thought to be due to rapid changes in blood sugar that can affect the integrity or physiology of smaller blood vessels like those in the retina (3).
The effect on macular degeneration has been inconclusive with some studies suggesting GLP-1RAs are protective and others showing a twofold increase in the risk for progression to wet macular degeneration. There have also been several studies that have shown a link between GLP-1 RAs and non-arteritic ischemic optic neuropathy (NAION). NAION is a condition that results in decreased blood flow to the optic nerve that can severely affect vision. Some studies suggest a twofold risk with this condition compared to normal, but this is about 1 in 10,000 patients who take GLP-1 RAs (4).
So, What Does it Mean for You?
The consensus among eye care physicians is that the benefits of GLP-1 RAs outweigh any risk currently. Even if the retina or nerves have been impacted, long term benefits to reduced blood sugar and weight loss can still be worth it to take these medications, but that decision should be made through discussions with primary care and your eye care provider.
When starting a glucagon-like peptide, an initial evaluation of the retina and optic nerve should be performed, especially for someone who has been diagnosed with diabetic retinopathy or macular degeneration. Yearly exams should be adequate moving forward, but if there are any sudden vision changes, you should contact your eye care provider right away for further evaluation.
Sources:
1. https://my.clevelandclinic.org/health/treatments/13901-glp-1-agonists
3. https://www.aoa.org/news/clinical-eye-care/public-health/glp-1-receptor-agonists-and-vision-risk
4. https://www.aao.org/newsroom/news-releases/detail/should-you-stop-taking-glp-1-drugs-like-ozempic
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