Semaglutide links to eye disorders in spotlight

With semaglutide and tirzepatide’s associations to eye disorders making headlines in recent days, GPs are warned that patients may present in their clinics with heightened safety concerns.
 
The Therapeutic Goods Administration (TGA) has confirmed that, to 5 May 2025, it has received 44 reports of eye disorders associated with semaglutide.
 
Of those, there were eight reports of blindness, two reports of blindness unilateral, eight reports of visual impairment, and 13 reports of optic ischaemic neuropathy.
 
Additionally, it received 13 reports of eye disorders associated with tirzepatide including one report of blindness, one report of central vision loss, and seven reports of optic ischaemic neuropathy.
 
The concern comes at a time when the medications are more popular than ever before, with an unprecedented demand for supply leading to a number of previous and current global shortages.
 
The medications’ recent links to eye disorders follow findings published in JAMA Ophthalmology about a potential increased risk of non-arteritic anterior ischemic optic neuropathy (NAION) in patients with diabetes treated with semaglutide.
 
‘Results of this study suggest a modest increase in the risk of NAION among individuals with type 2 diabetes associated with semaglutide use, smaller than that previously reported, and warranting further investigation into the clinical implications of this association,’ the study concluded.
 
The TGA has confirmed it is currently investigating this, including reviewing relevant medical literature and international adverse event reports.
 
However, Dr Gary Deed, Chair of RACGP Specific Interests Diabetes, told newsGP the recent spike in public concern is ‘not necessarily mentioning high-quality evidence’.
 
‘As GPs, you probably should get people with diabetes commencing any change in medication to make sure they’ve had timely diabetes eye assessments, to exclude any advancing retinopathy that the patient may not have been aware of, because they can be asymptomatic,’ he said.
 
‘The other sub-group is people with obesity. There are reports of changes in vision, but when we look at the studies that try to unpack or prove this, they’re not randomised controlled studies. In fact, they’re observational and only in a single centre.
 
‘The management of obesity requires a holistic approach. Medication is only one aspect of that care.’
 
Dr Deed added that the studies gaining attention were not set up to prove causation and do not standardise for concerns such as severity or duration of diabetes or smoking.
 
A TGA spokesperson added that while anyone can search the publicly available Database of Adverse Events Notifications, reporting of an adverse event ‘does not necessarily mean that a causal link with the medicine is established’.
 
‘Controlled clinical trials provide high-quality evidence about the safety and efficacy of new medicines and vaccines,’ the spokesperson told newsGP.
 
‘However, when therapeutic products are used in larger and more diverse population groups outside clinical trials, previously unrecognised side effects may be identified.
 
‘This is why the TGA undertakes post-market monitoring of all medicines, as well as other therapeutic goods, and encourages health professionals to report adverse events.
 
‘You don’t need to be certain, just suspicious. Every report is valuable and contributes to our ongoing safety monitoring.’
 
Log in below to join the conversation.

semaglutide TGA Therapeutic Goods Administration tirzepatide