If left undiagnosed or untreated, diabetic eye disease can result in serious and often permanent vision problems. Ozempic (Semiglutide) is now commonly prescribed for lowering blood glucose levels in patients with Type 2 diabetes mellitus (T2DM) with the thought being that better controlled T2DM will reduce diabetic complications including diabetic eye disease. Ozempic is also being prescribed as an appetite suppressant for the treatment of obesity which is a contributing factor in the development of T2DM and many other health problems. While the use of Ozempic has had some very promising results, there have been some scattered reports of visual side effects which we would like to address in this article.
The most common visual side effect of Ozempic has been blurred vision due to an eyewear prescription change which is actually a somewhat positive side effect once you understand the mechanism:
Inside of your eye and directly behind your pupil lies a small lens about the size of a plain M&M. When we are young, this lens is very flexible and changes shape allowing us to focus from distance to near.
High blood glucose levels can cause this lens to change shape and lose flexibility resulting in blurred vision and subsequent change in glasses prescription. This is often one of the first symptoms of Type 2 diabetes. It should be noted that this type of vision loss from diabetes is usually reversable, differing from diabetic retinopathy which often causes permanent vision loss – more to come on that.
Now, along comes Ozempic which is a very effective appetite suppressant leading to weight loss, decreased blood glucose, and hopefully preventing lens swelling and changes in vision and eyewear prescriptions. However, in patients who already have lens swelling which has resulted in an eyewear prescription change, the decreased blood glucose often causes the lens to go back to its natural state resulting in a different eyewear prescription and blurred vision until the glasses are changed.
As stated, the changes caused by diabetic lens swelling are reversible and usually do not cause permanent vision loss. However, Diabetic Retinal Disease (retinopathy) can cause permanent vision loss and often requires more invasive treatments. In theory, weight loss with early use of Ozempic will prevent obesity from causing diabetes and the development of retinal disease. However, recently there have been some reports that Ozempic may cause worsening of diabetic retinal disease in a small percentage of diabetic patients most of which already had some degree of diabetic retinopathy. This appears to be rare and studies in this area are preliminary and ongoing.
Although still early, Ozempic appears to have the potential to prevent or treat T2DM and hopefully reduce the incidence of diabetic eye complications. Keep in mind that this is only my opinion after 30+ years of caring for diabetic patients. Studies are still ongoing, and we will keep informed of any updates.
If you are diabetic and are taking Ozempic, please continue to consult with your endocrinologist or primary care provider and remember to have a thorough diabetic eye examination with myself or Dr. Sarah Board.
Thanks for reading!
Steve Reinders, OD