GLP- 1 RA and Eye Health w A Prof Racheal Niederer.

Are GLP-1 receptor agonists putting your patients’ eye health at risk? Here’s what you need to know.

GLP-1 receptor agonists are revolutionising diabetes management, offering significant weight loss and cardiovascular benefits. However, there is a potential link to eye disease, particularly in those with pre-existing conditions.

Recent studies suggest that while these medications improve overall health, they may cause a temporary worsening of diabetic retinopathy due to rapid improvements in blood glucose levels. This is important for primary care, as patients need appropriate assessment and counselling before starting treatment.

Before prescribing, ensure a recent retinal screening has been completed, especially for higher-risk patients. Close monitoring in the first few months is essential to detect any early complications.

Practical clinical pearls:

Rapid weight loss can worsen diabetic retinopathy.

Start low, go slow, and monitor the retina in diabetic patients.

Ensure retinal screening has been completed within the last 12 months before starting treatment.

If retinopathy is present, initiate cautiously and arrange closer ophthalmology follow-up.

Advise all patients to seek urgent review if they develop any visual symptoms.

Ocular complications are rare in non diabetics, but important to recognise early.

Report any suspected adverse events to Medsafe to support ongoing safety monitoring.

Guest bio:

Assoc Prof Rachael Niederer PhD, MBChB, FRANZCO

Ophthalmologist | Uveitis and Medical Retina Specialist

Rachael attended Auckland University Medical School from 1997–2002 and won the highly prized Sir William McKenzie Award for Early Excellence in Eye Research.

She completed her PhD on corneal nerves and keratoconus in 2008 and was awarded the Vice Chancellor’s Best Doctoral Thesis award.

Rachael completed her ophthalmology vocational training in both Auckland and Hamilton and, in the RANZCO final examination, achieved a gold Howsam Medal for the highest marks in Australia and New Zealand.

She completed her fellowship at Moorfields Eye Hospital in London, specialising in uveitis and medical retina. In 2016, she was appointed Senior Medical Ophthalmologist at Greenlane Hospital and, in the same year, was the RANZCO college representative for Auckland ophthalmology trainees.

In 2019, Rachael was appointed Senior Lecturer at the University of Auckland, Department of Ophthalmology.

In late 2025, she was promoted to Associate Professor at the University of Auckland, recognising her ongoing contributions to ophthalmology, education, and research.

Rachael’s research interests are extensive and include more than 140 publications in international journals and over 60 presentations at New Zealand and international conferences. She is an investigator in the Zoster Eye Disease Study and has a particular interest in uveitis and the epidemiology of eye disease.

She is also committed to reducing inequalities in access to eye care within the community.

Resources:

MedSafe NZ Pharmacovigilance - https://medsafe.govt.nz/

American Diabetes Association Screening Guidelines - https://diabetes.org/diabetes/medication-management/retinal-screening

Green Lane Eye Clinic - https://aucklandeye.co.nz/

Rachael Niederer - Auckland Eye - https://www.aucklandeye.co.nz/specialist/assoc-prof-rachael-niederer/

GLP-1 Receptor Agonists Overview - NICE - https://www.nice.org.uk/guidance/ta543

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#GLP1 #EyeHealth #DiabetesCare