What is the association between Semaglutide (Ozempic) and vision loss?

From the Guidelines

Ozempic (semaglutide) has been associated with an increased risk of rapidly worsening diabetic retinopathy, and patients taking this medication should be closely monitored for vision changes, particularly if they have pre-existing diabetic retinopathy. According to the most recent guidelines from the American Diabetes Association, published in 2025 1, GLP-1 receptor agonists like Ozempic have been shown to be effective in managing diabetes, but may also increase the risk of retinopathy, especially in patients with established diabetic retinopathy. The exact mechanism is not fully understood, but it may involve the effects of GLP-1 receptor agonists on blood vessels in the eye during significant blood sugar reductions.

Some key points to consider when taking Ozempic include:

• Regular eye exams are crucial for all diabetes patients, especially when starting medications like Ozempic 1
• Patients with pre-existing diabetic retinopathy may be at higher risk for complications, and should be closely monitored by their healthcare provider 1
• Vision changes such as blurred vision, decreased visual acuity, or eye pain should be reported to a healthcare provider immediately, as they could indicate diabetic retinopathy complications 1
• The American Diabetes Association recommends implementing strategies to help people with diabetes reach glycemic goals to reduce the risk or slow the progression of diabetic retinopathy, which may involve more frequent eye check-ups during the initial treatment period 1.

Overall, while Ozempic can be an effective medication for managing diabetes, patients should be aware of the potential risks and take steps to monitor their vision and overall eye health.

From the FDA Drug Label

In a 2-year trial involving patients with type 2 diabetes and high cardiovascular risk, more events of diabetic retinopathy complications occurred in patients treated with OZEMPIC (3.0%) compared to placebo (1. 8%). The absolute risk increase for diabetic retinopathy complications was larger among patients with a history of diabetic retinopathy at baseline (OZEMPIC 8.2%, placebo 5.2%) than among patients without a known history of diabetic retinopathy (OZEMPIC 0.7%, placebo 0. 4%). Rapid improvement in glucose control has been associated with a temporary worsening of diabetic retinopathy. The effect of long-term glycemic control with semaglutide on diabetic retinopathy complications has not been studied. Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy. Inform patients to contact their physician if changes in vision are experienced during treatment with OZEMPIC [see Warnings and Precautions (5. 3)].

Ozempic may be associated with an increased risk of diabetic retinopathy complications, particularly in patients with a history of diabetic retinopathy.

• Patients with a history of diabetic retinopathy should be monitored for progression of diabetic retinopathy.
• Changes in vision should be reported to a physician during treatment with Ozempic. 2

From the Research

Ozempic and Vision Loss

• Ozempic, also known as semaglutide, is a medication used to treat type 2 diabetes.
• There is evidence to suggest that semaglutide may be associated with an increased risk of worsening diabetic retinopathy (DR) 3, 4, 5.
• A meta-analysis of randomized controlled trials found that semaglutide was not associated with an increased risk of DR compared to controls, but subgroup analysis showed an increased risk compared to placebo, particularly in older patients or those with long diabetes duration 4.
• Another study found that GLP-1 receptor agonists, including semaglutide, were associated with an elevated risk of rapidly worsening DR in patients with type 2 diabetes 5.

Mechanism of Action

• The exact mechanism by which semaglutide may affect vision is not fully understood, but it is thought to be related to its effects on glycemic control and cardiovascular risk reduction 3.
• Metformin, another diabetes medication, has been shown to have protective effects on the retina and may reduce the risk of DR 6, 7.

Patient Factors

• Patient age and diabetes duration may be factors that increase the risk of DR when using semaglutide 4.
• Patients with preexisting high-risk DR, poor baseline glycemic control, and using insulin may be more vulnerable to the potential retinal harms of semaglutide 3.