The Effects of GLP-1 Receptor Agonists on Ocular Diseases: A Narrative Review

Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are incretin-based agents widely used in the management of type 2 diabetes mellitus and obesity. Beyond their metabolic effects, accumulating evidence indicates that these drugs may significantly influence ocular tissues, potentially exerting neuroprotective and anti-inflammatory actions, while also raising concerns regarding retinal and optic nerve complications. Aim: The aim of this narrative review was to summarize the current evidence on the effects of GLP-1RAs on ocular diseases, with particular emphasis on diabetic retinopathy, glaucoma, age-related macular degeneration, cataract, non-arteritic anterior ischemic optic neuropathy, and other visual disturbances. Methods: A structured literature review was conducted using PubMed and Google Scholar. Cohort studies, systematic and narrative reviews, case reports, pharmacovigilance analyses, and preclinical investigations published up to May 2026 were analyzed. Results: Experimental data suggest anti-inflammatory, antioxidant, vascular, and neuroprotective effects of GLP-1RAs on ocular tissues. Clinical studies report possible benefits in glaucoma and age-related macular degeneration, whereas findings in diabetic retinopathy remain inconsistent. Reported adverse events include transient worsening of diabetic retinopathy, blurred vision, cataract, and possible semaglutide-associated non-arteritic anterior ischemic optic neuropathy. These outcomes may be influenced by rapid HbA1c reduction, weight loss, baseline ocular disease, and vascular risk factors. Conclusions: GLP-1 receptor agonists may exert both protective and adverse ocular effects. Further prospective studies are required to determine their long-term ophthalmic safety and clinical significance.