Overview: GLP-1 Medications and Vision Loss 

Reports of infrequent but serious vision complications, most notably Non-Arteritic Anterior Ischemic Optic Neuropathy (NAION), have prompted extensive medical review and expanding litigation involving the GLP-1 medications Ozempic and Wegovy (semaglutide). 

NAION is caused by reduced blood flow to the optic nerve and can result in sudden, painless, and often permanent vision loss. While GLP-1 medications play a critical role in managing diabetes, obesity, and cardiovascular risk, these findings underscore the importance of informed monitoring and risk disclosure. 

This guide summarizes: 

• The current medical evidence 

• Regulatory responses 

• The evolving legal landscape surrounding NAION claims 

Medical Evidence: Association Identified, Causation Not Confirmed 

Key Findings 

• A large systematic review and meta-analysis of 78 randomized controlled trials reported an increased risk of NAION among semaglutide users: Odds Ratio (OR): 3.92 (95% CI, 1.02–15.02) 

• Other studies suggest the relative risk may be 2–7 times higher compared to similar diabetes or weight-loss medications. 

What the Numbers Mean 

• OR 3.92: Semaglutide users had nearly four times the odds of developing NAION compared to non-users in the analyzed studies. 

• 95% Confidence Interval (1.02–15.02): Because the range does not cross 1.0, the finding is statistically significant. The wide range reflects uncertainty due to NAION’s rarity. 

• Important Caveat: These studies show association, not definitive causation. Additional research is ongoing. 

Absolute Risk Remains Very Low Despite the elevated relative risk: 

• NAION remains classified as “very rare” by regulators. 

• Available data suggests an increase from roughly 0.02% to 0.04% in treated versus control populations, approximately 1 in 10,000 users. 

Other Eye-Related Outcomes 

Diabetic Retinopathy (DR) 

• Recent large reviews show no increased risk of diabetic retinopathy: OR 1.04 (95% CI, 0.92–1.17) 

• Earlier findings in the SUSTAIN-6 trial are now understood to reflect rapid glucose lowering, not a direct toxic effect. 

General Eye Disorders 

• Most studies report no elevated risk of general eye conditions with semaglutide. 

Tirzepatide (Mounjaro/Zepbound) 

• Research is ongoing. Most current evidence focuses on semaglutide. 

• Monitoring recommendations apply to all GLP-1 medications. 

• The FOCUS clinical trial is underway to assess long-term effects on diabetic eye disease. 

Regulatory and Clinical Perspective 

• The European Medicines Agency (EMA) and the World Health Organization (WHO) have recommended updating semaglutide labeling to list NAION as a very rare side effect. 

• This reflects heightened awareness but does not establish confirmed causality. 

• Clinically, for most patients, the metabolic and cardiovascular benefits of GLP-1 therapy outweigh the low absolute risk of NAION. 

Proactive Patient Care: Essential Guidance 

Do Not Stop Medication Abruptly 

Discontinuing GLP-1 therapy without medical supervision can cause serious metabolic consequences. Always consult your provider first. 

Get a Baseline Eye Exam 

A comprehensive, dilated eye exam is recommended before starting treatment (or as soon as possible if already using GLP-1 medications), especially for patients with: 

• Diabetes or hypertension 

• Prior eye disease 

• Anatomical risk factors such as a “crowded” optic nerve head 

Monitor for Warning Signs 

Seek immediate medical attention if you experience: 

• Sudden, painless vision loss in one eye 

• New or worsening blurred vision 

• Dark spots or shadows in your visual field 

• Loss of color discrimination 

Discuss Your Individual Risk 

Shared decision-making with your prescribing physician is essential. 

Legal Landscape: Focus on Failure to Warn 

Central Allegations 

Plaintiffs allege that manufacturers: 

• Failed to adequately warn about the risk of NAION 

• Did not sufficiently inform healthcare providers of emerging safety signals 

• Limited patients’ ability to give informed consent for a potentially permanent injury 

Key Legal Updates (as of November–December 2025) 

State Court – New Jersey (MCL) 

• The New Jersey Supreme Court has ruled that NAION vision-loss cases will be handled separately from gastrointestinal injury claims (gastroparesis). 

• Both tracks are coordinated by Judge Gregg A. Padovano in Bergen County. 

Federal Court 

• MDL 3094 (Eastern District of Pennsylvania) currently focuses on severe GI injuries, with approximately 2,900+ cases pending. 

• Due to the growth of NAION claims, Eli Lilly has filed a motion seeking to centralize federal vision-loss lawsuits, either as a new MDL or a dedicated track within MDL 3094. A decision is pending. 

Don’t give up on your claim. 

Free, confidential consultations are available. Our team closely tracks NAION litigation and provides experienced guidance to help you understand your legal options and pursue appropriate compensation. 

Schedule Your Free Consultation 

Disclaimer: This article provides general information regarding medical findings and potential legal matters. It does not constitute medical or legal advice. Consult a healthcare provider regarding medication decisions and an attorney for case evaluation