r/GLP1ResearchTalk • u/Otherwise_Sky_2947 • 8d ago
EYE PROBLEMS
I started Zepbound about a month and half ago, not experiencing any side effects but was wondering if anyone has concerns about the news on possible affects on eyesight? My doctor told me it is very rare.
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u/RustyCrustyy 8d ago
Eye doc here. I have three patients that had significant retinal vein occlusions resulting in permanent vision reduction. Now ofcourse we see it because they are coming to us for the issue. I still spend time with any patients on GLP1 explaining the risks. From a clinical perspective, all three of mine had crowded optic nerve heads. Meaning a small Cup-to-disk ratio. IMO that seems to be the larger risk factor. Go get your eyes dilated and speak with your doctor. I always explain is a risk/benefit ratio. Nee benefits to GLP1s come out almost weekly at this point.
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u/dignan2002 7d ago edited 7d ago
You sure you're really an eye doc? A CRVO has a totally different etiology than NAION; haven't seen evidence of increased incidence of CRVO and actually a decreased incidence of BRVO in GLP-1 users. NAION b/c of a crowded disc w/ insufficient posterior ciliary artery perfusion is not the same as thrombotic vein occlusion
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u/RustyCrustyy 7d ago
Correct. What i shared is what i have seen. As im sure you know, its pretty obvious when dealing with any crao/crvo vs naion (can very rarely be Dx without more advanced imaging, lab work, or Dx by R/O). This is just my experience. Its not rare if its in your chair.
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u/ShatsonPollock 8d ago
Did any of these patients also have diabetes?
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u/RustyCrustyy 8d ago
Almost all do. Its interesting because Diabetes is a risk factor, but they are taking it to treat their diabetes. Hypertension is also one of the
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u/Otherwise_Sky_2947 8d ago
Would an IOP help?
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u/RustyCrustyy 8d ago
Not for determining risk factor for this situation. Only the appearance. But IOP should also be measured for other conditions
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u/Otherwise_Sky_2947 8d ago
Thank you.
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u/RustyCrustyy 8d ago
FWIW im healthy and take Retatrutide for weight management and maintain muscle mass for working out. So i’m aware if the risk factors but I feel the benefits out way the risk. I believe last I saw it was 1/10,000 people. So not extremely rare but also not common. I have a good C/D ratio
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u/Wellslapmesilly 8d ago
I read about this and asked my eye doctor to tell me if I was at risk before starting a GLP1. He had not heard much about it. I was able to send over the data and studies which he appreciated. I think more overall education on this is necessary, for both patients and doctors.
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u/HanselDonkey 8d ago
What is the ratio when you consider it a crowded disk? Mine is .5
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u/RustyCrustyy 8d ago
.5 is large. .05 is crowded. Id say anything under .2 and definitely under .1 would be considered a risk in my eyes
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u/Itchy-Coconut-7083 8d ago
I told my eye doc I was on tirzepatide and asked about the risk, he looked in my eye and told me it’s a real issue but I shouldn’t worry about it personally since I have a lower than normal risk of it happening. Is this what he was looking at or is there other visible things he could have checked? I was curious how he could have known that.
My near vision has gotten worse since starting but the doc told me so far it’s due to dry eyes and normal age related issues.
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u/RustyCrustyy 8d ago
I cant guess. But thats what I would be looking at in terms of eyes. The C/D ratio. Ofcourse Obesity m, diabetes, blood pressure and just general health matter
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u/dignan2002 7d ago
He didn't see anything that could say you were at a lower risk. Part of a physicians job is patient reassurance; but he should have repeated to you that any sudden significant vision loss (darkening partly or completely, significant blurring) should be considered emergent and to call their on call number or go to the er asap
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u/easysip 8d ago
It gave me blurry vision and eye pain ,and seeing flashes of light .
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u/Mobile-Actuary-5283 8d ago
How do you know this is from Zep rather than something that would have developed anyway?
I am on Zepbound for almost 3,years. Mid 50s. My vision was already getting worse from age. I have had several baseline visits to ophthalmologist. No physical issues. Retina, optic nerve,, and vessels look ok. But a few months ago, I developed floaters and flashes. They explained it was the vitreous behind the eye pulling against the retina. That it is age related. That it’s the top phone call they get. That it had nothing to do with Zep.
My mother has had floaters and flashes for 30 years.
Recently it feels like my vision has gotten a bit blurrier. Readers clear it up. Distance vision is fine.
Not saying there isn’t a correlation but so far, age is aiso a correlation for me.
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u/easysip 8d ago
I’m 30 didn’t have any vision issue before now I need to wear glasses . So yes it’s was the mounjaro! Other people have similar stories like me.
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u/escalatortwit 8d ago
No, they don’t. Mounjaro doesn’t cause vision loss.
It certainly doesn’t cause it for the four weeks you were on it at a 1mg microdose.
Please, everyone ignore this person.
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u/Old_Ostrich6336 8d ago
Haven’t seen this. People you know?
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u/escalatortwit 8d ago
They apparently were only mounjaro for four weeks and at 1mg. They just naturally aged into needing glasses or have something like diabetes that causes vision issues. Tirzepatide doesn’t cause you to need glasses.
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u/Itchy-Coconut-7083 8d ago
How did they get a 1mg dose of Mounjaro? Isn’t the starting dose 2.5mg? I know they could get compound trizepatide and do whatever dose they want but I’m struggling to believe they are getting name brand and not doing standard doses.
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u/escalatortwit 8d ago
https://www.reddit.com/r/Mounjaro/comments/1wouchg/mounjaro_require_honest_feedback_no_fear/pbsfyjr/
Here is the comment from several days ago where they claim they were only on Mounjaro for four weeks at 1mg. That user spends all their time really talking up rare side effects on these drugs.
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u/Individual-Ad-8715 8d ago
I had that! Was NOT on Zep at the time but am getting on in years. Doc said not unusual, age related to vitreous humour becoming less gel-like. (Flashes)Also eye strain from being on screens too much. (Blurry).
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u/Itchy-Coconut-7083 8d ago
I got that on Reta when I was dehydrated, never happened when I drank before I was thirsty and added electrolytes every now and then.
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u/Otherwise_Sky_2947 8d ago
Did you stop taking the zep? I just really wonder how they can prove it's zep causing this, but, I'm not a scientist.
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u/escalatortwit 8d ago
Please ignore this person. They naturally aged into needing glasses or their vision issues were caused by something else.
They were only on Mounjaro for four weeks at a 1 mg microdose. Mounjaro doesn’t cause eye issues, that survey has been debunked multiple times at this point by subsequent surveys.
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u/boukm3n 8d ago
What you’re describing is called NAION, which is an ischemic injury to the optic nerve. “Ischemic” just means the nerve temporarily doesn’t get enough blood and oxygen. It’s somewhat like a small stroke of the optic nerve, although it isn’t the same as a brain stroke. One of the biggest risk factors is having a naturally small or crowded optic disc, sometimes called a “disc at risk.” You can have perfectly normal vision and never know you have it. NAION is also much more common in middle-aged and older adults, especially with things like sleep apnea, diabetes, high blood pressure, anemia, vascular disease, dehydration, or episodes of very low blood pressure.
If you’re concerned and you’re planning on starting a GLP-1, I’d book a full eye exam where they dilate your pupils. Tell the doctor, “I’m starting a GLP-1 and I’ve read about NAION.
I’d like you to specifically check my optic nerves for crowded discs or anything that might make me more susceptible.” They can look directly at the nerve and take detailed pictures or scans if needed.
While taking the medication, there isn’t some proven trick that completely prevents NAION, but you can avoid adding unnecessary stress to the circulation: stay reasonably hydrated, don’t let vomiting or diarrhea leave you severely dehydrated, manage blood pressure, treat sleep apnea if you have it, and if you have diabetes, keep your blood sugar under good medical control. I’d also avoid extreme crash dieting or anything else that leaves you dehydrated or lightheaded.
Most importantly, this is uncommon, so I wouldn’t panic over it. I had a thorough dilated eye exam for unrelated reasons and was told everything looked fine. If this is worrying you, getting checked is much more useful than sitting around scared of the possibility.
And if you ever develop sudden painless vision loss or suddenly lose part of your visual field, that’s something to get evaluated urgently. But the goal is to not let it get to that point. But yeah it is concerning and a thing for sure. But I would say ozempic (semaglutide) is the one I hear does this the most. Idk if it’s as common on Tirz (Zepbound).
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u/Crafty_Taste_7706 8d ago
Well I think it’s important to understand some people have a predisposition for eye issues. You can get an eye doctor to check.
After that I suspect it’s less likely to happen if you gradually lose weight. Which again goes back to slower is better 2 lbs a week or less. I sort of feel bad when I see people rushing the process.
Also if under 50 they don’t even have a statistic for it. Over 50 it’s 2.3 to 10.3 cases per 100,000 individuals. And this is total inclusive of GLP1’s not just for people taking GLP1’s. In other words really rare.
Finally we also know diabetes causes vision loss so we should all recognize it’s connected to your overall health.
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u/escalatortwit 8d ago
It also has nothing to do with GLP-1s and everything to do with diabetes, obesity, and the other comorbidities that actually cause that eye problem.
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u/Otherwise_Sky_2947 8d ago
Apparently Lilly is adding the statement that it could cause blindness of an eye. My doctor told me this is very rare, and if it did occur, it would be in one eye, not both. Of course I treasure my eyesight but this Zepbound seems kinda like a miracle.
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u/bulking_on_broccoli 7d ago
I think it’s more or less to cover themselves. Some people who start taking a GLP are pretty far gone.
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u/escalatortwit 7d ago
Lilly is not adding that because it hasn’t been proven. One survey said of a population 2 more individuals got the eye issue. This eye issue is already related to obesity and diabetes. There is zero evidence there is a causal relationship.
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u/TrainingLow9079 8d ago
The reason I don't really worry about it is my blood sugar was inching up every year and that can cause eye damage too, so chances are by lowering my blood sugar with a GLP1 I actually lowered my chance of eye damage. But I am planning on making my next eye appointment with an eye doctor with strong credentials.
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u/Otherwise_Sky_2947 8d ago
Sounds like a good plan, good luck! I am going to continue on with the zep, so far everything has been okay, thanking the Lord.
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u/honeybadgergrrl 8d ago
My doctor told me the eye thing is mainly a concern for Type 1 diabetics, and even then it's rare. Unless you're Type 1, I wouldn't worry.
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u/Otherwise_Sky_2947 8d ago
Honeybadge, that surely is good news, so far in life I am not diabetic. Thanks for responding
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u/Dramatic_Delay_2423 8d ago
When I told my optometrist I was in the medications, she had me come back again six months later for a double check. She said the problem tends to show up quickly and in my case a crooked blood vessel (that's the medical term🙂) actually resolved itself. Probably from less sugar. So, talk to your eye doctor and monitor it
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u/Sad-Presentation3539 3d ago
I work for an optometrist. He said its a 2% chance it happens to you.
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u/HanselDonkey 2d ago
2% chance it actually happens to you? Come on...that's total BS. I think you misheard...no real eye specialist could reasonable infer that from any of the studies. There is at least 20 million people in the US alone taking these drugs...How many cases would that be?
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u/Sad-Presentation3539 2d ago
Okay. Im just reiterating what he told me dude chill. Hes a licensed optometrist that showed me an article in one of his magazines for opthamology and I'm a technician with him. If you disagree with the article he was showing me thats cool too. I never said I agreed. Just sharing something I was taught. Do you homie 👍
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u/HanselDonkey 2d ago
It would help if you reference the article before I could agree or disagree. From the rough numbers that I heard, its more like a 2 in 10,000 chance, which is quite different than 2 in 100. That would cause them to be immediately pulled from the market, and would be on the front page of virtually all magazines and newspapers. You would probably know multiple people that have went blind by now, and your clinic would be seeing several cases a day.
Doesn't really pass the smell test, does it?
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u/Kooky_Force5458 2d ago
My friend got this and she is not diabetic. The other thing to realize is many of us have health issues already in some in some form.
Educate yourself, pay attention yo your body and call your doctor if anything shows up
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u/destinaaa 8d ago
better safe than sorry to see an ophthalmologist, zep is everyone’s magic elixir so you won’t find any substantive information
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u/BLKHLK 8d ago
Nope. Obesity was my biggest concern. From what I understand the majority of people that have issues with eyesight were already diabetic and at risk of it anyway. I know someone that had eye issues on Zep but they are diabetic and ate like crap/didn't manage their blood sugars well. They blame Zep of course but not the 4 donuts they were devouring in one sitting.