Pregnancy and eyesight

Vision changes during pregnancy

Pregnancy is a time when the female body goes through a lot of changes. Expecting mothers often know to anticipate morning sickness or lower back pain, but are surprised when their vision changes. In fact, the hormonal and physical changes that accompany pregnancy can commonly affect eyesight. Fortunately, vision problems are usually of most concern during the third trimester and often minor and temporary. Eyesight typically returns to normal after your baby is born. Some vision problems associated with pregnancy, however, may require medical attention, and can indicate more serious conditions.

1. Blurred Vision

Changes in hormones, metabolism, fluid retention, and blood circulation can all affect your eyes and your eyesight during pregnancy. These may cause the thickness and curvature of the cornea of your eye to increase slightly (cornea oedema). It’s a small change, but will affect how well your glasses or contacts correct your vision – in some cases your prescription will need to be altered. It’s also why laser eye surgery isn’t recommended during pregnancy. Women wearing Ortho-K lenses at night to correct their vision may also experience changes in their treatment, some needing to revert back to spectacles for the duration of their pregnancy. Vision changes are temporary and will often reverse themselves within a few months of your baby’s birth.

What to do: You may not need to do anything if the changes don’t bother you. However, if you are finding problems with your vision, make an appointment to visit one of our optometrists so that they can advise whether an interim change in your ocular correction will be of benefit.

2. Dry and Irritated Eyes

Pregnancy and breast feeding is often accompanied with drier and more easily irritated eyes. This is because pregnancy hormones decrease tear production.This may be particularly relevant to those women who wear contact lenses – which may become uncomfortable during your pregnancy.

What to do: Use non-preserved artificial tears to lubricate your eyes and ease dryness. Check the active ingredients with your optometrist, GP or pharmacist to make sure these are safe for pregnancy. If you wear contact lenses, you will require a compatible eye drop. Contact lenses may need to be worn part time or stopped all together for the duration of the pregnancy so for those who are wearing contact lenses full time, a pair of back-up spectacles should be organised before the third trimester.

3. If you are taking glaucoma medication prior to pregnancy and notice blurred vision or severe headache.

During pregnancy, intra-ocular pressure inside the eye may decrease temporarily and if a woman is on glaucoma medication, it may need to be adjusted. Blur or headache can mean that these medications should be reviewed. There is also some concern of foetal risk from glaucoma medications during the first trimester, and when breast feeding, but the effects are largely unknown.

What to do: 

When you find out you are pregnant it is advised to make an appointment with your optometrist and ophthalmologist for discussion. Depending on how advanced a mother’s glaucoma is, the optometrist and ophthalmologist will weigh the risks of the removing the mother from medication against the potential risks to the baby, or breast-fed infant. Ocular surgery is a viable option in some cases and poses little risk to the developing baby.

If glaucoma medications have been adjusted during pregnancy and the mother experiences visual abnormalities or unusual headaches, she should contact her optometrist or ophthalmologist immediately.

4. If your GP / Obstetrician has informed you of risk of gestational diabetes, or you have diabetes prior to pregnancy, and you notice blur or focusing difficulties.

If there is any concern about gestational diabetes, you should be regularly monitored throughout your pregnancy for damage to the blood vessels in the retina (diabetic retinopathy). If these changes are picked up at an early stage, your optometrist, GP and ophthalmologist can work together to determine the best course of action to preserve your sight while being safe for baby.

What to do: An optometrist will work closely with your GP, and if needed an ophthalmologist, at this time and monitor any changes to your retina using Digital Retinal Imaging and Optical Coherence Tomography (OCT) Scanning. Regular frequent appointments these health professionals will be required throughout your pregnancy.

5. Temporary loss of vision, light sensitivity, blurred or double vision, auras, swelling and puffiness around the eyelids and the appearance of flashing lights with or without dark floaters or veils.

Certain visual symptoms during pregnancy can be cause for concern. Pre-eclampsia is a potentially serious problem that occurs in 5% to 8% of pregnancies which is marked by high blood pressure and the presence of protein in urine. The above vision changes can be associated with this condition and indicated need for prompt emergency care.

What to do: If you experience any of these vision symptoms, call your doctor or optometrist immediately or go to the hospital emergency room. Pre-eclampsia can progress rapidly and cause bleeding problems and other serious complications.

Pregnancy is an exciting time for any expectant parents. Changes in a vision should not be ignored and it appropriate for any concerned mother-to-be to seek care from a clinical optometrist, who will be able to give feedback on any cause for concern and refer where appropriate.