What percentage of patients taking Mounjaro (tirzepatide) experience vision changes?

Vision Changes in Mounjaro (Tirzepatide) Patients

Tirzepatide has not been documented to cause retinopathy, optic neuropathy, or other significant ocular adverse effects, and there is no established percentage of vision changes specifically attributable to this medication. 1

Evidence-Based Safety Profile

The current evidence demonstrates that tirzepatide does not carry the same vision-related risks as medications known to cause ocular toxicity:

• No documented retinal or optic nerve toxicity: Unlike chloroquine, hydroxychloroquine, ethambutol, or amiodarone, tirzepatide has not been associated with retinopathy or optic neuropathy in clinical trials 1

• Extensive clinical trial data: The SURPASS clinical trial program (SURPASS 1-5) involving thousands of patients treated with tirzepatide for up to 3 years did not identify vision changes as a significant adverse event 2, 3, 4

• No routine ophthalmologic monitoring required: Based on current evidence, there is no need for specific ophthalmologic screening for patients taking tirzepatide 1

Clinical Context and Comparison

To understand why vision changes are not a concern with tirzepatide, consider medications that do cause documented ocular toxicity:

• Chloroquine/hydroxychloroquine: Can cause retinopathy affecting photoreceptors and retinal pigment epithelium, with risk increasing at doses >5.0 mg/kg and with prolonged duration of use 5

• Ethambutol: Causes retrobulbar neuritis with decreased visual acuity or red-green color discrimination in a dose-dependent manner, affecting 18% of patients receiving >30 mg/kg per day 5

• Amiodarone: Causes corneal microdeposits in nearly all patients and rarely optic neuropathy that may progress to blindness 6

Practical Management Recommendations

For patients on tirzepatide reporting visual symptoms:

• Evaluate symptoms as you would for any patient with diabetes or obesity, without assuming causation from tirzepatide 1

• Continue standard diabetes eye care: Patients with diabetes should undergo regular ophthalmologic examinations as part of routine diabetes management, regardless of tirzepatide use 1

• Consider alternative causes: Visual complaints in this population are more likely related to underlying diabetic retinopathy, refractive changes from weight loss, or unrelated ocular conditions 1

Common Adverse Events with Tirzepatide

The documented adverse events with tirzepatide are predominantly gastrointestinal, not ophthalmologic:

• Gastrointestinal effects: Nausea (31%), diarrhea (23%), vomiting (12%), and constipation (5%) are the most common adverse events 7

• These effects are dose-dependent, typically mild-to-moderate in severity, and occur primarily during the dose-escalation period in the first 20 weeks 4