The following is a summary of recent guidance given by the American Optometric Association regarding GLP-1 receptor agonists and the eye:
GLP-1 receptor agonists are powerful drugs for managing chronic diseases like diabetes, but they can rarely cause serious eye problems, such as:
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NAION (a type of optic nerve damage),
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worsening diabetic retinopathy (DR),
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and worsening age-related macular degeneration (AMD).
These issues may happen due to quick changes in blood sugar levels after starting the medication. People over 50 with a “disc at risk” (a certain optic nerve shape) are especially vulnerable to NAION.
What eye doctors should do:
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Perform a full, in-person, dilated eye exam before starting the drug.
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Take baseline photos of the retina (and possibly OCT scans) for high-risk patients.
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Follow up more closely during the first 12–18 months on the drug.
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Warn patients about possible vision risks, especially if they have other conditions like diabetes, high blood pressure, or high cholesterol.
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Tell patients to come in right away if they notice any vision changes.
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Stop the drug if NAION is diagnosed.
Bottom line: Regular eye exams and better patient communication are key to preventing serious vision loss in people taking GLP-1 drugs.
