GLP-1s: What the Doctors Didn’t Know Then, But Must Start Talking About Now

Note: This article shares personal experience and currently available medical information. If you have diabetes or are taking a GLP-1 medication, discuss these concerns with your doctor.

I began a GLP-1 medication in 2021 to help manage my blood sugar. Over time, I noticed my clothes fitting more loosely. Because it was a once-weekly injection, I did not closely track changes in appetite or cravings, but the difference in how my clothes fit was noticeable. I had stopped weighing myself weekly about 10 years earlier, so the change felt unexpected but positive.

Around 2023, as public interest in these medications grew, I read more about them. I realized that the ongoing “food noise” I had experienced for most of his life had quieted. I felt a new sense of balance around food.

In early 2025, while on vacation, I developed sudden spots of blurriness in my vision. At first, I thought my glasses needed cleaning. By the third day, it was clear something was wrong. I kept my concerns in check during the trip but sought care immediately upon returning home. Medical tests confirmed non-arteritic anterior ischemic optic neuropathy (NAION), sometimes described as a stroke of the optic nerve. I had never heard of NAION before. The vision loss that developed was permanent.

I searched for possible causes and found reports of lawsuits in the United States against Novo Nordisk alleging NAION linked to Ozempic. I did not take my next dose. When I contacted my endocrinologist about the diagnosis, her response was brief and concerned: “Oh no.” She didn’t advise me, however, to stop taking the GLP-1. She had heard some early discussion about the possible link but had not yet seen any patients affected. This occurred in early 2025, around the time initial reports and lawsuits were emerging.

A 2024 study from researchers at Massachusetts Eye and Ear (Hathaway et al.) analyzed patient records and found that people with type 2 diabetes prescribed semaglutide had approximately 4.28 times the risk of NAION compared to those on other diabetes medications. The authors noted this was an observational study and that further research is needed to establish causality. (https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255)

Subsequent studies have shown mixed results. In June 2025, the European Medicines Agency (EMA) Pharmacovigilance Risk Assessment Committee (PRAC) reviewed available data and concluded that NAION is a very rare side effect of semaglutide (up to 1 in 10,000 people), but is indeed a side effect. The EMA recommended updating product information, advising patients to seek immediate medical attention for sudden vision changes, and stopping the medication if NAION is confirmed. (https://www.ema.europa.eu/en/news/prac-concludes-eye-condition-naion-very-rare-side-effect-semaglutide-medicines-ozempic-rybelsus-wegovy)

Highlighting the growing international consensus on this risk, the Danish Patient Compensation association ruled in late 2025 to grant financial payouts to patients who developed NAION after taking Ozempic or Wegovy. This marked a major shift in Novo Nordisk’s home market, where the government had previously adjusted its healthcare system to heavily subsidize and reimburse Ozempic users, only to later tighten restrictions due to skyrocketing public costs. (https://www.insurancejournal.com/news/international/2025/11/24/848799.htm)

NAION occurs when blood flow to the optic nerve is reduced, leading to sudden, usually painless vision loss in one eye. It is rare overall, but new attention has been drawn to it because more and more unexpected cases have arisen. The music artist, Robbie Williams, was diagnosed with NAION and is now also trying to raise awareness.

Many people who develop NAION have a structural abnormality called a “disc at risk” — a small or crowded optic disc that may make the nerve more vulnerable to changes in fluid balance, blood pressure, or swelling. GLP-1 medications can cause rapid changes in weight, blood sugar, and fluid dynamics, which some researchers hypothesize may contribute in susceptible individuals, though the exact mechanism is not fully understood.

There is no cure for NAION; at this time, the vision loss is permanent. Not everyone with a disc at risk will develop NAION while taking a GLP-1 medication. If you have diabetes or are taking (or considering) a GLP-1 medication, consider the following.

Note: By the time there is vision loss, it is already too late to salvage the eyesight.

1. Researchers have explored options such as doxycycline for its potential anti-inflammatory and neuroprotective effects in early reports. Some suggest it may help limit further damage if given promptly after diagnosis. If diagnosed, it is vital to immediately consult a neuro-ophthalmologist to ask if any acute interventions, clinical protocols, or anti-inflammatory treatments are appropriate for your specific case.
2. See an ophthalmologist and ask for an OCT (Optical Coherence Tomography) scan. This non-invasive test can help assess the optic nerve head and identify whether you have a disc at risk. This information can help you make an informed decision about starting or continuing the medication.
3. Be aware of symptoms. Sudden, painless vision loss or blurring in one eye (often noticed upon waking) requires immediate medical attention.
4. Protect the fellow eye. As a young girl learning about the five senses in school, I remember thinking about which one I would dread losing the most. For me, it was always sight. This is why the risk to the second eye freezes me with terror at times. After NAION in one eye, there is an estimated 15–25% risk of it occurring in the second eye over several years. Managing other risk factors (such as blood pressure and sleep apnea) is critical. (https://www.aao.org/eyenet/article/naion-diagnosis-and-management)

To the medical community prescribing these medications: give your patients all the information that you can so that they can weigh the benefits of these effective treatments against their individual risks, and make informed decisions. Most people understand that GLP-1 medications can cause digestive side effects — this is well known and clearly listed in the product information. But would anyone expect to lose their eyesight from taking this medication?

When I started the medication in 2021, my doctor was not aware of this potential risk. I might still have chosen to take it knowing the information available now — it is a miracle drug. I simply wish I had known earlier so I could have made a fully informed choice as to whether or not to take the risk to lose my eyesight. That is why I am sharing this.

GLP1, #Ozempic, #Diabetes, #NAION, #PatientStory