Michelle Fennell was at her desk when her right eye went heavy, then blurry, then narrowed to a fishbowl. Two weeks later a doctor diagnosed NAION — nonarteritic anterior ischemic optic neuropathy — a sudden, often permanent loss of vision caused by reduced blood flow to the optic nerve. He asked what she was taking. “He said right away, stop taking Ozempic.” She had started it six months earlier for Type 2 diabetes.
Fennell, 53, is one of dozens suing Novo Nordisk (NVO); a smaller number of suits name Eli Lilly (LLY), maker of Zepbound. Weitz & Luxenberg has filed more than 90 cases in New Jersey since 2025; a separate group sits in federal court in Philadelphia. Both companies are fighting. Novo’s senior medical officer, Tina Vilsbøll, lead author of a company-funded analysis of randomized trials that found no increased risk: “I do not see causality.” Lilly says the studies do not prove causation and its medicines are safe.
What the evidence actually says
It disagrees with itself. Some studies find no added risk. One from a specialized eye center reported nearly an eightfold increase. Researchers classify NAION differently because it has no diagnosis code of its own, and many patients on GLP-1s carry the other conditions that raise the risk independently — diabetes, heart disease, high blood pressure, sleep apnea. Europe’s medicines agency concluded in June 2025 that NAION is a very rare side effect and added a label warning; the U.K., Japan and Australia carry warnings too. In Denmark, Novo’s home, 27 patients have been compensated upward of $1.5 million by the government’s patient-compensation authority, with 38 cases pending. Novo says payouts are not evidence of causality. There is no U.S. warning; the FDA has been investigating since late 2024 and will not say when it will decide. Harvard’s Aaron Kesselheim notes the agency usually wants a credible association before it labels anything.
The number that matters most is the smallest one. Even if semaglutide doubled the risk, doctors told the Journal, that would still mean roughly two people in 10,000 developing the condition. Jay Vandegriff, 69, a software founder who lost two-thirds of the vision in his left eye, is one of them, and he no longer skis in fog or ties a fly. “I’d almost pay anything to get my eyesight back.”
The one thing to do
Dr. John Chen of the Mayo Clinic puts the decision cleanly: for patients who need the drug for diabetes or heart disease, the benefits probably outweigh the risk; for someone who wants to lose five pounds, probably not. And in 2025 the American Optometric Association recommended that anyone starting a GLP-1 get an eye exam to check the optic nerve. A physically small or crowded nerve — a “disc at risk” — is the strongest anatomical predictor. “If a patient has a disc that does look scary, then that’s a conversation,” said the association’s president. “But I don’t think every person being on a GLP-1 needs to worry about going blind.”
Our read
This is the same pattern as Friday’s annuity lawsuit: an allegation, a denial, and a household caught between them. The desk’s advice does not depend on who wins. Two in 10,000 is small; permanent is not. An eye exam before starting, and a call the same day if vision changes, is the whole risk-management program, and it costs less than a month of the drug.
Lilly is held in the healthcare sleeve as one of the two companies that own this market; Novo, down 15% this year, is not. Neither position turns on the litigation, and neither should. The Risk Atlas calls this event risk, and the defense is what it has always been: position caps, and no single lawsuit big enough to change the year.