Evaluation of the Effect of Semaglutide Use on Ocular Surface and Tear Function: A Cross-Sectional Study
Abstract
Objective: The aim of this study was to evaluate ocular surface and tear function parameters in patients receiving semaglutide therapy and to investigate possible changes with respect to dry eye disease.
Methods: This cross-sectional study included 40 patients receiving semaglutide therapy. Patients wearing contact lenses or with a history of refractive or any other ocular surgery, chronic ocular surface or systemic autoimmune disease, topical ocular medication use, or concomitant systemic medication carrying an anticholinergic burden were excluded in order to limit confounding. Both eyes of each patient were evaluated, yielding a total of 80 eyes. The mean duration of semaglutide use was 3 months. Tear break-up time (TBUT) and the Schirmer test were used to evaluate ocular surface and tear function. No control group was included. TBUT and Schirmer test results were analyzed using descriptive statistics.
Results: Among the 80 eyes of the 40 patients included in the study, the mean duration of semaglutide use was 3 months. The mean TBUT value was 9.1 ± 3.3 seconds (range, 3-15 seconds), and the mean Schirmer test result was 8.8 ± 3.7 mm (range, 3-16 mm).
Conclusion: A mean TBUT of 9.1 ± 3.3 seconds and a mean Schirmer test value of 8.8 ± 3.7 mm in patients receiving semaglutide suggest that tear film stability and tear secretion warrant detailed evaluation in this patient group. However, because this study lacked a control group and pre-treatment measurements, no causal relationship can be established between these findings and semaglutide use. The current literature on the effects of GLP-1 receptor agonists on the ocular surface remains limited and heterogeneous. Controlled, prospective studies incorporating pre- and post-treatment assessments are needed to determine the true effect of semaglutide on ocular surface and tear function.
Keywords
Semaglutide, GLP-1 receptor agonist, Dry eye, Tear break-up time, Schirmer test, Ocular surface
Ethical Statement
References
- Craig JP, Nichols KK, Akpek EK, Caffery B, Dua HS, Joo CK, et al. TFOS DEWS II definition and classification report. Ocul Surf. 2017;15(3):276-83. doi:10.1016/j.jtos.2017.05.008.
- Bron AJ, de Paiva CS, Chauhan SK, Bonini S, Gabison EE, Jain S, et al. TFOS DEWS II pathophysiology report. Ocul Surf. 2017;15(3):438-510. doi:10.1016/j.jtos.2017.05.011.
- Wolffsohn JS, Arita R, Chalmers R, Djalilian A, Dogru M, Dumbleton K, et al. TFOS DEWS II diagnostic methodology report. Ocul Surf. 2017;15(3):539-74. doi:10.1016/j.jtos.2017.05.001.
- Stapleton F, Alves M, Bunya VY, Jalbert I, Lekhanont K, Malet F, et al. TFOS DEWS II epidemiology report. Ocul Surf. 2017;15(3):334-65. doi:10.1016/j.jtos.2017.05.003.
- Gomes JAP, Azar DT, Baudouin C, Efron N, Hirayama M, Horwath-Winter J, et al. TFOS DEWS II iatrogenic report. Ocul Surf. 2017;15(3):511-38. doi:10.1016/j.jtos.2017.05.004.
- Fraunfelder FT, Sciubba JJ, Mathers WD. The role of medications in causing dry eye. J Ophthalmol. 2012;2012(1):285851. doi:10.1155/2012/285851.
- Katipoğlu Z, Abay RN. The relationship between dry eye disease and anticholinergic burden. Eye (Lond). 2023;37(14):2921-5. doi:10.1038/s41433-023-02442-x.
- Wilding JPH, Batterham RL, Calanna S, Davies M, Van Gaal LF, Lingvay I, et al. Once-weekly semaglutide in adults with overweight or obesity. N Engl J Med. 2021;384(11):989-1002. doi:10.1056/NEJMoa2032183.
- Lincoff AM, Brown-Frandsen K, Colhoun HM, Deanfield J, Emerson SS, Esbjerg S, et al. Semaglutide and cardiovascular outcomes in obesity without diabetes. N Engl J Med. 2023;389(24):2221-32. doi:10.1056/NEJMoa2307563.
- Sun Y, Zhang Y, Shi F, Li Y, Wang C, Yu F, et al. Characterization and role of glucagon-like peptide 1 receptor in the lacrimal gland: novel insights into diabetic dry eye pathogenesis. Am J Pathol. 2025;195(4):797-810. doi:10.1016/j.ajpath.2024.12.003.