Pregnancy impacts many parts of a woman’s body, and the eyes are no exception. The most common vision complaints we hear from pregnant women are that, particularly during their third trimester, (a) their eyeglass correction fluctuates and (b) their eyes have difficulty adjusting between near and far images. Consequently, we advise women to postpone new refractions or contact lens fittings until after delivery. Most visual disturbances resolve by six weeks postpartum.
Diabetes is an important consideration because diabetic retinopathy can progress more rapidly during pregnancy. We recommend a dilated exam within the first trimester and follow up exams every three months (or as advised by their eye doctor) in patients at risk for diabetic retinopathy. Any diabetic woman considering pregnancy should have a baseline eye exam before conception.
There are other less common ocular conditions that occur during pregnancy. Occasionally women may experience mild ptosis (droopy eyelids) during pregnancy. Eyelid hyperpigmentation can occur due to a melonocyte-stimulating hormone. Vascular eye tumors, such as hemangiomas, may become first symptomatic in pregnancy because of the increased maternal blood volume and cardiac output. Finally, preclampsia and eclampsia can have ocular signs in the retina and can cause visual loss. Fortunately, many of these eye abnormalities frequently resolve spontaneously after delivery, but patients should still seek care for vision problems.
Many prescription and over the counter medications, including eye drops, have not been clinically tested in pregnant women due to ethical and administrative obstacles. Therefore, women should consult with their eye doctor and gynecologist before using ocular medications during pregnancy.