GLP 1 Blindness Risk | Should You Be Worried?

Okay, so GLP-1 medications, like Ozempic

and Wegovy, are now in mounting legal

battles over potential vision loss and

blindness, which is a really big deal,

right? It's not like just a side effect

of having a rash. No, it's you're you've

permanently lost vision because of this.

But, the big question is what is the

true risk, right? If you're taking this,

is this something that could actually

happen to you? So, in today's video,

we're going to break down not only what

the updated science says about that

risk, who is most vulnerable and should

be paying attention and be concerned

that maybe you have a higher risk of

this, and then toward the end we'll also

talk about what questions to ask your

eye doctor if you are either taking

these medications right now or you are

considering going on a GLP-1 in the

future. So, first, a lot of people are

taking these GLP-1 medications. It's

estimated that about 12% of the US

population is either currently taking or

has at least tried one of these drugs.

Mostly for diabetes, but also a lot of

people are using it for weight loss as

these GLP-1s not only help with your

blood sugar control, but also suppress

appetite quite a bit. And there's a lot

of research showing improvements for

cardiovascular risk with these meds, not

only just directly from the med, but

also because of reduced obesity. And as

people shed the pounds, we also tend to

see in a reduction in other metabolic

disease. So, not only are a lot of

people taking this medication, but it's

also a very powerful med. And with

powerful meds, we need to be observant

and careful about side effects,

especially ones with such grave side

effects such as vision loss and

blindness. Now, the most serious side

effect of taking these GLP-1s that's

been reported is the development of an

NAION

or a non-arteritic anterior ischemic

optic neuropathy, which is basically a

long way of saying that the blood flow

to the optic nerve has been reduced or

blocked, essentially causing a stroke

within the optic nerve. Symptoms of an

NAION usually include sudden,

painless visual loss that affects often

one eye, but it usually is altitudinal.

That means that the lower half of your

vision just disappears or the upper half

of your vision goes away. Sometimes

people may even notice a color vision

loss or a desaturation called dys-

chromatopsia, where one eye the color

vision will just suddenly seem more

desaturated

than the other. But the hard reality of

this type of vision loss is that it's

usually permanent. Sometimes there can

be a subtle improvement that we see

within the first month or two afterward,

but most cases the vision loss is

permanent. It's not coming back. So,

with this, I think the logical next

question is what is the risk? If you

start taking a GLP-1 drug, what is your

likelihood of getting this serious side

effect? Well, several observational

studies have been published and some

have even estimated that you have about

a two-fold

risk of getting one of these eye

strokes. But, of course, the absolute

risk of getting one of these is very,

very low. It's considered quite rare,

only about one in 10,000 cases. And that

means if you're taking a GLP-1, you have

about a two in 10,000 cases chance per

year. However, I'll just add that, you

know, the criticism is that a lot of

people who are taking GLP-1s already

have an increased risk of having this

type of eye stroke to begin with because

they have diabetes, they have high blood

pressure, high cholesterol, other

factors. And while yes, the risk may be

low, again, the consequences are very

real. In fact, in back in 2024 when the

first observational studies reporting

this side effect were coming out, we did

have several people in the comments say

that they had this exact thing. They had

a stroke within the eye from taking

GLP-1s, and it just breaks my heart. So,

if you yourself have already had this

and you're just trying to learn more,

my heart goes out to you. I'm sorry that

this happened. And I'll just add that I

hope that your doctors are not only

helping you maximize the usable vision

you have left, but perhaps they referred

you to a low vision specialist who is

helping rehab kind of how you use your

vision and still functionally live your

best life. I don't think eye doctors

talk about that enough, but that is

another component or aspect to the

profession and how we can help people.

And if you haven't had access to any

resources like that, I'll try to include

some in the show notes below. Now, there

are a few other risk factors I think are

really important to know about for this

risk of developing this type of eye

stroke. However, I do want to just

quickly mention a few other interesting

findings that have linked GLP-1 to

causing eye issues. First of which is

that they've reported in the SUSTAIN 6

trial that people who go on GLP-1s, if

they have bleeding in the back of the

eye from diabetes, they have diabetic

retinopathy, their risk of worsening

bleeding

goes up. So, if you're somebody who is

diabetic and you recently got put on a

GLP-1 or you're thinking about it, and

you know you already have some level of

retinopathy inside the eye, then it's

really good to follow up with your eye

doctor so they can make sure that's not

getting worse and that doesn't need

additional treatment. Also, there's

another small study reporting that

people who are diabetic and at risk of

macular degeneration, their risk of

neovascular macular degeneration also

goes up. But again, very low absolute

risk. And of course, as always, to prove

that I'm not making this stuff up, I'll

include uh research notes, uh all the

publication and resources in the show

notes for you if you want to read into

it yourself. I know we flash these

publications here on screen, but I found

out a lot of people just listen to the

show and they don't always necessarily

watch the video part here on YouTube, so

I like to call out that again, research

is in the show notes. And if you're

heading that way, hit that like and

subscribe button down below, too,

because that does help the channel out

and helps this video reach more people

to help people save their vision. So,

thank you for all your support and help.

Okay, so who is most at risk of getting

this NAION from the use of GLP-1s? Well,

the American Optometric Association,

they have an evidence-based optometry

committee that basically look at all of

the information that's been published

and then they reported a clinical report

that did a really good summary of who's

most at risk. People who have a higher

risk are those over the age of 50, who

happen to have diabetes, high blood

pressure, or hyperlipidemia.

In addition to this, people who have

obstructive sleep apnea may be at higher

risk, and people who have a small optic

nerve, or what we call a disc at risk.

Essentially, some people have larger

optic nerves and some people have

smaller ones. If you have a larger optic

nerve, that means it's less congested

and blood flow may be able to get

through the nerve uh more readily versus

somebody with small congested nerve,

then their blood vessels may be more

constricted. There may also be a higher

risk for people who happen to have optic

nerve head drusen, which is another

condition, but this is where calcium

deposits build up in the nerve, and

again, that'll help kind of make the

nerve congested. But either way, to know

if you have a small optic nerve or

something like optic nerve head drusen

that may increase your risk of getting

this, uh make sure to see your eye

doctor. They use an instrument like this

called a slit lamp and they'll examine

the optic nerve and let you know if

yours is smaller and at risk. Now, if

you happen to be taking a GLP-1 or

you're considering it, just know that it

is now recommended to have a baseline

in-person comprehensive dilated eye exam

either before starting it or within 1

month of starting these meds. And don't

be surprised if doctors recommend

following up at least every 12 to 18

months just to have a closer watch. But,

of course, uh, if you notice any vision

changes to definitely call your doctor

uh, right away. Now, with this video,

I'll add that I am in no way telling you

to either stop these medications without

talking first to your prescribing doctor

or to avoid taking these medications

because we know that, uh, not only can

they help quite a bit with diabetes and

weight loss, but there's also some

cardiometabolic

uh, protective effects from them, too.

But, from an eye care standpoint, I

think it's just important to understand

that there is this risk and there's

certain symptoms to be aware of and some

people who are uh, at increased

vulnerability and to follow up with your

eye doctor and just make sure

everything's okay. And if you don't have

a regular eye doctor and you live here

in the US, I will at least put a doctor

locator in the show notes so you can

reconnect and and find a doctor near

you. But, with this video, I hope that

you found it not only educational and

interesting, but from here, I hope you

have a fantastic day. Thanks for

watching. Keep an eye on it.

And we'll see you in the next

one.