Medical News Today (MNT)Wegovy Users May Have 5 Times Risk of Vision Loss Than Those on Ozempic

Wegovy users face 5 times the risk of ischemic optic neuropathy compared to Ozempic users, despite sharing the same active ingredient, with men at 3 times greater risk than women, according to a British Journal of Ophthalmology analysis of FDA adverse event reports.

Clinical Considerations

• The higher semaglutide dose in Wegovy (2.4 mg vs 2.0 mg in Ozempic) is the leading hypothesis for the elevated ION risk, suggesting a dose-dependent mechanism.
• No ION cases were reported with oral semaglutide (Rybelsus), raising questions about delivery route as a contributing variable.
• Experts caution that underlying vascular and metabolic risk factors in GLP-1 users, including diabetes and obesity, confound causation in this retrospective analysis.
• Missed diagnoses remain a concern: NAION, central retinal artery occlusion, and ischemic optic neuropathy share overlapping presentations with GLP-1-related ocular events.

Practice Applications

• Screen patients newly prescribed Wegovy or high-dose semaglutide for baseline optic nerve and visual field status.
• Counsel male patients on Wegovy specifically about elevated ION risk and symptoms warranting urgent evaluation.
• Coordinate with prescribing physicians when GLP-1 patients present with new visual symptoms, regardless of POCUS or initial exam findings.

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