From the Guidelines
Yes, kaleidoscope vision could potentially be linked to Ozempic (semaglutide) use, and the patient should seek immediate medical attention to rule out any serious conditions. This visual disturbance, which may present as fragmented or distorted vision similar to looking through a kaleidoscope, is not a commonly reported side effect of Ozempic, but GLP-1 receptor agonists like Ozempic have been associated with certain eye-related complications in some patients, particularly those with pre-existing diabetes or diabetic retinopathy 1. The mechanism may involve rapid blood sugar changes affecting blood vessels in the retina, as suggested by the effects of GLP-1 receptor agonists on glucose-dependent insulin release and glucagon secretion 1. Other possible explanations include changes in blood pressure or dehydration from the medication's side effects.
The patient's healthcare provider should evaluate this symptom promptly, as it could indicate a serious condition requiring prompt assessment. The provider may need to temporarily discontinue Ozempic while investigating the cause of her visual disturbances through appropriate eye examinations and possibly adjust her treatment plan accordingly. It is essential to prioritize the patient's safety and well-being, considering the potential benefits of Ozempic for weight management and glycemic control, as highlighted in the AGA clinical practice guideline on pharmacological interventions for adults with obesity 1.
Key considerations in managing the patient's care include:
- Monitoring for any changes in vision or other potential side effects of Ozempic
- Evaluating the patient's overall response to treatment, including weight loss and glycemic control
- Adjusting the treatment plan as needed to minimize risks and optimize benefits, based on the patient's individual clinical profile and needs, as recommended by the AGA guideline 1
- Considering alternative treatment options, such as lifestyle modifications or other pharmacological agents, if necessary, to ensure the patient's safety and well-being.
From the Research
Possible Link to Ozempic
The patient's experience of kaleidoscope vision while taking Ozempic (semaglutide) for pre-diabetes and weight control may be related to the medication.
- The study 2 reported ophthalmic complications associated with the use of semaglutide, including nonarteritic ischemic anterior optic neuropathy, bilateral papillitis, and paracentral acute middle maculopathy.
- However, the study 3 found no significant increase in the risk of non-arteritic anterior ischemic optic neuropathy (NAION) or ischemic optic neuropathy (ION) in patients prescribed semaglutide or any GLP-1RA compared to matched controls.
Ophthalmic Complications
The patient's symptoms may be related to ophthalmic complications associated with semaglutide use.
- The study 2 reported that 9 patients experienced ophthalmic complications, including visual acuity and visual field defects, while taking semaglutide.
- The study 4 found that semaglutide was not associated with an increased risk of diabetic retinopathy (DR) compared to controls, but subgroup analysis showed that semaglutide was associated with an increased risk of DR in older patients or those with long diabetes duration.
Semaglutide and Vision
The relationship between semaglutide and vision problems is still being researched.
- The study 5 reported that semaglutide was associated with an increased incidence of nausea, vomiting, and diarrhea, but did not observe increased hypoglycemia rates or significant differences in the incidence of diabetic retinopathy.
- The study 6 found that semaglutide combined with metformin significantly improved glycemic control, insulin resistance, weight, BMI, and lipid profiles in patients with type 2 diabetes mellitus (T2DM) who are overweight or obese, but did not report any vision-related adverse effects.