What is the issue of Ozempic and eye problems?
Many people are prescribed Ozempic (and related medications) for type 2 diabetes mellitus and weight loss. There are reports of increased risk of diabetes-related retina complications after starting Ozempic. Complications include loss of vision (usually, not permanent when treated), vitreous hemorrhage, macular edema, and the need for laser treatment or injection treatment for diabetic retinopathy. There is also an association of Ozempic and ischemic optic neuropathy.
How does Ozempic cause eye problems?
It appears that Ozempic does not directly cause damage to the eyes. Rather, Ozempic may cause rapid lowering of blood sugar (especially, when used with other medications for diabetes). It is well-known that any treatment that rapidly lowers blood sugar may initially cause a worsening of diabetic retinopathy. It is as though the retina becomes adjusted to higher-than-normal blood sugars in diabetes. And then, when blood sugars drop, the retina becomes “starved.” The effect wears off as the retina becomes used to the lower blood sugar levels. Furthermore, in the long-run, the retina will be healthier with improved blood sugar control.
Who is at risk for retina problems and loss of vision with Ozempic?
Risk factors for retina problems from Ozempic include: prior damage from high blood sugar (diabetic retinopathy), rapid lowering of blood sugar, and continued use of other diabetes medications. Eyes with crowded optic discs (from small scleral opening or optic disc drusen) from birth are at increased risk of optic nerve damage.
What can I do to prevent loss of vision with Ozempic?
If you have diabetes, see an ophthalmologist (or better yet, a retina specialist) for an eye exam before starting Ozempic. If you already have vision-threatening changes, early treatment will prevent worsening with Ozempic. In addition, routine monitoring of the retina during treatment with Ozempic may prevent permanent loss of vision from diabetic retinopathy. In addition, the optic nerve may be evaluated to determine if it is at risk of ischemic optic neuropathy.
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