In the current issue of JAMA Ophthalmology, Hathaway and colleagues have observed a potential association between the use of semaglutide, a glucagon-like peptide-1 receptor agonist (GLP-1 RA), and a diagnosis of nonarteritic anterior ischemic optic neuropathy (NAION). They leveraged data from their institution’s centralized clinical registry and thoughtfully assured the validity of the NAION diagnosis by case note confirmation. To assess a potential association, they evaluated 2 groups, patients diagnosed with type 2 diabetes (T2D) and patients living with obesity. Each group was defined by semaglutide exposure vs non-GLP-1 RA therapy for either diabetes or obesity, respectively. Importantly they performed propensity score matching against age, sex, hypertension, hyperlipidemia, T2D, obstructive sleep apnea, and coronary artery disease. In both groups, the hazard ratio showed an association of semaglutide with the development of NAION. A temporal association was observed where the NAION event was more likely to occur within the first year of a semaglutide prescription.