At Lake Norman Eye Care, our mission is to keep our community informed about the latest health concerns that may affect vision. Recently, there has been growing discussion around Ozempic® (semaglutide), a medication widely prescribed for type 2 diabetes and weight management, and its potential link to vision problems.
What is Ozempic®?
Ozempic is a GLP-1 receptor agonist, designed to help regulate blood sugar levels in people with type 2 diabetes. More recently, it has gained attention for its role in weight management. While it has clear health benefits, some patients have reported vision changes after starting the medication.
Semaglutide (brand names Ozempic®, Wegovy®, Rybelsus®) has transformed diabetes care and become widely used for weight management. While the medication benefits many patients, recent research and regulatory reviews have identified a very rare but serious eye condition — non-arteritic anterior ischemic optic neuropathy (NAION) — that appears more often in some people taking semaglutide. Because NAION can cause sudden, irreversible vision loss, it’s important for patients and clinicians to be aware of the possible association, the symptoms, and recommended actions.
What is NAION?
NAION is an acute loss of blood flow to the front (anterior) portion of the optic nerve. It typically presents as sudden, painless vision loss in one eye, often with an altitudinal visual field defect (loss of the top or bottom part of vision). NAION is usually non-arteritic (not related to inflammation of arteries) and is most commonly seen in people with vascular risk factors (diabetes, high blood pressure, small “crowded” optic nerve anatomy, sleep apnea, etc.). Because there is no proven effective treatment to reliably restore lost vision, prevention and early recognition are critical.
A number of observational studies and case reports have raised concerns about an increased incidence of NAION among people exposed to semaglutide:
Who might be at higher risk?
Studies and case reports suggest that people with existing vascular risk factors and those with an “optic disc at risk” (a small, crowded optic nerve head anatomy) may be more susceptible. Other risk contributors include: long-standing diabetes with end-organ damage, hypertension, older age, severe sleep apnea, and any condition that predisposes to low optic nerve perfusion. Because semaglutide can cause marked weight loss and changes in blood pressure or hydration in some people, clinicians have hypothesized that these physiologic changes might contribute to risk in vulnerable individuals — although the mechanism is not fully understood.
What symptoms should prompt immediate evaluation?
If you are taking semaglutide (Ozempic, Wegovy, Rybelsus) — or any GLP-1 receptor agonist — contact an eye care professional right away if you experience:
- Sudden, painless decrease in vision in one eye
- New visual field defect (loss of part of vision, especially top or bottom)
- New flashes or floaters (less specific but worth evaluation)
- Any sudden change in vision
Early evaluation by an optometrist, ophthalmologist, or neuro-ophthalmologist is essential. While there is no consistently effective treatment to reverse NAION, timely assessment matters for diagnosis, for preventing risk to the fellow eye, and for coordination with your primary care provider or prescribing clinician.
How Lake Norman Eye Care approaches this issue
At Lake Norman Eye Care, Dr. Mason Williams and Dr. Angela Harris prioritize patient safety and informed decision-making. Our approach includes:
- Baseline comprehensive eye exam for patients starting semaglutide (especially if diabetic or with vascular risk factors).
- Optic disc evaluation (to look for a small/crowded optic nerve head that may increase NAION risk).
- Education about NAION symptoms and the importance of prompt reporting.
- Coordination with your primary care physician, endocrinologist, or bariatric team if vision changes occur or if risk factors are present.
- Closer monitoring for patients on semaglutide who already have diabetic eye disease, optic disc crowding, or other risk factors.
If you’re already on semaglutide and have no visual symptoms but have diabetes or other vascular risks, continuing your medication may still be the right choice — the benefits for glycemic control and cardiovascular risk reduction are substantial. Decisions about starting, stopping, or switching medications should be individualized and made in partnership with your prescribing clinician, incorporating your eye health and the small but real NAION signal.
What you should do now
If you are taking semaglutide and notice any sudden changes in vision, call Lake Norman Eye Care or present to urgent eye care immediately.
If you are considering starting semaglutide and have diabetes, known optic nerve crowding, sleep apnea, or other vascular risk factors, discuss the potential NAION signal with your prescribing clinician and consider a baseline eye exam.
Continue routine diabetic eye exams — these remain one of the most important steps to protect your vision.
Schedule an exam / Contact Lake Norman Eye Care
If you have concerns or want a baseline optic nerve evaluation before starting or while taking semaglutide, call Lake Norman Eye Care to schedule a comprehensive exam with Dr. Mason Williams or Dr. Angela Harris. Early communication between your eye doctor and prescribing clinician helps keep vision safe while optimizing overall health.
References and further reading (key papers / sources)
1. Hathaway JT, et al. Risk of Nonarteritic Anterior Ischemic Optic Neuropathy in Patients Prescribed Semaglutide. JAMA Ophthalmol. 2024. (Matched-cohort study; first large tertiary-center signal).
2. Grauslund J, et al. Once-weekly semaglutide doubles the five-year risk of nonarteritic anterior ischemic optic neuropathy in a Danish cohort of 424,152 persons with type 2 diabetes. Int J Retin Vitr. 2024;10:97. (Large national cohort showing ~2× risk).
3. European Medicines Agency (PRAC) — safety conclusion: NAION is a very rare side effect of semaglutide medicines (Ozempic, Wegovy, Rybelsus); June 2025. (Regulatory assessment and recommendations).
4. Coverage and summaries from major centers (Mass Eye & Ear / Harvard) and mainstream reporting summarizing the clinical implications.
