Pregnancy and your eyes

Pregnancy is a very happy time for most people but it has it’s special considerations for women with certain conditions prior to pregnancy. Let’s explore some of those and what is advised for the best outcome for you, your baby and your vision.

Your obstetrician may advise you of this but many do not, your vision can change while you are pregnant and again after delivery. It doesn’t happen all the time but enough of the time that it should be kept in mind. There is no way to predict what kind of change might occur. My sister got better with one, worse with the next and nothing at all with her third child. I didn’t change with either one of mine.

This is also why we can’t do Lasik while pregnant or nursing. The changes in the cornea due to the hormones of pregnancy will effect your overall end result.

There are also changes related to internal pressure of the eye during pregnancy and after. The internal pressures will lower slightly. So that patient that is either a glaucoma patient or at risk for glaucoma will see their numbers reduce during this time. Unfortunately they will usually go back up at some point following delivery. Use of glaucoma drugs during pregnancy is tricky due to the class of drugs and the potential effects on the fetus. Therefore we welcome the lower pressures during this time.

Diabetic patients need to have a complete and thorough eye exam including retina exam prior to conception. The risk of proliferative diabetic retinopathy during pregnancy is increased because of the vascular changes caused by pregnancy as well. These must be monitored carefully and closely, including monthly examinations.

Macular edema is an increased risk for a small percentage of mothers. This may resolve after delivery but there is a chance that this could remain permanent.

Hypertension and the risk for pre-eclampsia and Eclampsia are also special considerations for the pregnant visual system. These conditions will be managed by the obstetrician but in co-management with the eye care provider.

The bottom line is a comprehensive eye exam prior to conception and at recommended intervals for pre-existing or new ocular conditions is advised. Proper education of the mother and appropriate co-management with other health care providers is optimum. And being very careful and taking proper precautions with drug use is essential.

Don’t think that you shouldn’t get your eyes checked simply because you are pregnant. It may not be the best time to get a new prescription for glasses or contact lenses. It is absolutely not the right time to discuss Lasik. But it is still important that it go on your list of care you give the mother during this time when her body is going through so many changes.

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