Pregnancy and the eyes

Posted by iChild, June 19, 2019 2:45 PM

By Sona Thakerar, McOptom & Sports Vision Practitioner

It is important to note vision and eye health can be affected through various stages of pregnancy as well as post-partum when breastfeeding.

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Common ocular symptoms experienced by those who are pregnant include, itchy, burning, gritty, watery feeling to the eyes, intermittent blurry vision.

The above symptoms are in most cases caused by temporary physiological changes to the eyes.

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Dry Eye: This is a very common result of hormonal changes  in a pregnant woman’s body. Hormone changes ultimately affect tear production and lack of lubrication on the ocular surface will manifest itself in ocular irritation and discomfort. Artificial tears are great in these instances and readily available just be sure that they are “pregnancy safe” drops.

Lid Changes: pigmentation around the eyes and lids known as melasma can be quite common, alongside droopy lids, ptosis, both of which are caused by hormones affecting melanocyte production and the muscle controlling the movement of the upper lid.

Having the health of your eyes checked during pregnancy is fine especially if you are suspicious, however determining reliable prescription results during pregnancy can be unlikely so I would always suggest holding off on spectacles till a couple of months post-delivery.

Visual changes: whilst this can be affected by tear film instability the major cause tends to be changes to the corneal curvature. This is a result of swelling of the cornea, also known as corneal oedema which is caused by the hormonal effect of fluid build-up within the eye. Changes to the curvature of the lens which sits within the eye also leads to visual disruption. The job of the lens is to accommodate vision for near visual tasks such as reading. Changes in the curvature of the lens once again due to hormones, can lead to temporary loss of accomodation and therefore difficulties with focusing on targets up close.

Contact lens intolerance  during pregnancy is not uncommon due to the structural changes of the cornea and inefficiency of tear production. Both of these ocular changes will lead to poorly fitted lenses and therefore discomfort. It may be an idea to cease lens wear until after delivery if artificial tears are not aiding comfort.

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Visual field changes: are mostly temporary and thought to be a result of pregnancy induced enlargement of the pituitary adenoma within the brain that can press on areas of the brain associated with functioning vision.

The immune defences of a pregnant woman will be re-directed towards protecting the baby, but this often leads to the mother herself becoming vulnerable to infectious diseases such a conjunctivitis. Interestingly certain chronic eye conditions, such as uveitis (in its non-infectious form) seem to improve during the course of pregnancy.

Pre-eclampsia is associated with raised blood pressure throughout pregnancy and can lead to its more dangerous counterpart eclampsia. The delicate blood vessel network at the back of the eyes can be affected by these 2 conditions causing signs and symptoms that resemble hypertensive retinopathy, such as haemorrhaging and leaking of fluid from these blood vessels as optic nerve changes. If you suffer from pre-eclampsia or eclampsia make sure to get your eyes examined at least once during the course of your pregnancy and pay attention to more serious visual symptoms of flashing lights, blind spots in vision, diplopia and reduced vision which require immediate attention.

Diabetic Retinopathy- this is more of an issue for those who have been suffering from diabetes prior to pregnancy as it can trigger retinal changes such as leaky blood vessels and in more extreme cases retinal detachments. Gestational diabetes does not appear to create as much of an issue with regards to eye health but worth noting.

There is an exhaustive list of potential visual problems that could arise or be triggered by pregnancy but above are the main and most important conditions to look out for. Most visual symptoms experienced will resolve upon delivery of the baby however the take home message is that if you feel unsure with your eyes during your pregnancy don’t be afraid to book up for an eye examination. As mentioned it is never a problem for us to check eye health and important in some cases to avoid irreversible damage. It is just the prescription element of the eye exam that would be considered irrelevant at this point in time so we would recommend waiting approximately 2 months post-delivery in order that hormone levels are restored, the exception to this would be if you are breastfeeding as hormone levels are still fluctuating during this time.

By Sona Thakerar, McOptom & Sports Vision Practitioner

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