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YOUR EYES IN PREGNANCY: During pregnancy, various physiological changes take place in your body due to the hormonal effects of the placenta.(The placenta enables the mother to transfer nutrients and oxygen to the baby via the umbilical cord). These placental hormones have effects on most organ systems, including the eyes. We shall first discuss some physiologic (normal) changes , second some pathologic (abnormal) changes, and last we will mention which eye medications might have detrimental effects on your baby (either via your breast milk or via the placenta).
The physiological changes include the following: 1: The normal intra-ocular pressure may decrease slightly due to certain hormonal and circulatory changes. This could be advantageous to patients suffering from Glaucoma, a condition where the raised intra-ocular pressure damages the optic nerve that transmits visual information to the brain.
2: The sensitivity of the pregnant mother's cornea also decreases significantly due to the associated fluid retention of ocular tissues (Especially during the last trimester of pregnancy). This may cause problems for contact-lens wearers who may traumatize their corneas more than usual, resulting in chronically red, irritated eyes and relative contact-lens intolerance.
3: This tendency to fluid-retention affects your refraction (meaning that your current spectacles or contact-lenses may temporarily be either too weak or too strong, depending on your specific refractive error). It is important to note that this is usually a temporary change, and that you should refrain from having your eyes retested during the latter stages of pregnancy and for at least the first 6 weeks after childbirth.
The following are some of the pathological effects of pregnancy which need to be considered: 1: Diabetic patients should routinely be seen at least yearly by their ophthalmologist, and even more often during pregnancy, because of the tendency for diabetic eye disease to worsen due to the hormonal effects of the placenta.
The early stages of diabetic retinopathy usually stay quite stable, but the more advanced stages (especially the proliferative stages) tend to progress. It is therefore important for women with advanced diabetic eye disease to seriously take their visual future into consideration when planning their families or deciding to become pregnant, and these decisions should only be made after consultation with their ophthalmologist.
The proliferative or advanced diabetic eye changes should be treated by laser therapy and be stabilized before planned pregnancy.2: Pregnancy is a state of hypercoagubility; this means that your blood tends to clot more easily due to certain changes in the consistency of the blood components. It is therefore important for a pregnant woman to be relatively active and ambulant to keep the circulation from slowing down too much, to prevent thrombosis of the cerebral vessels (which might lead to defects in your field of vision and other more serious neurological complications).
3: Some pregnant women develop very high systemic blood pressures, especially during their first or second pregnancies - a condition called pre-eclampsia or toxemia of pregnancy. This causes the development of hypertensive retinopathy with bleeding in the retina which may progress to permanent visual impairment if untreated.
4: Malignant melanoma is a type of pigmented skin cancer that tends to behave more aggressively during pregnancy. This type of cancer can also start inside the eye and may also show accelerated growth due to the hormonal effects of pregnancy.
5: Certain pituitary gland tumors may enlarge suddenly during pregnancy and become symptomatic for the first time, presenting with headache, decreasing vision and blank spots in the visual field, due to pressure on the optic nerve pathways.
Last, we will mention some common eye medications that may have an effect on the unborn or breast-fed baby: 1: Diamox is a type of diuretic used in the treatment of Glaucoma that may cause abnormalities in the fetus and should be avoided during pregnancy. Alternative medication should be substituted.
2: Any of the topically used beta-blocker eye drops also used for treating Glaucoma may induce premature labor, or may be transferred to the breast feeding baby via your breast-milk and have effects on the baby's heart, and should also be avoided during pregnancy and afterwards during breast feeding.
3: If you are using any other medication during pregnancy, check with your doctor whether it is safe to continue, and always let your ophthalmologist know that you are pregnant when you visit him, so that he may prescribe medication that is safe and harmless to both you and your baby!
If you have any further questions regarding your eyes in pregnancy, please consult your eye specialist.