Pregnancy can cause physiologic changes throughout a woman’s body and the eyes are no exception. Many of these changes are relatively minor and completely reversible. Because the developing fetus requires nutrients for normal development, nutritional demands on the mother increase. For this reason supplements are often advised. This is particularly important in some parts of the world where an adequate diet may be lacking. One consequence of a poor diet with a lack of vitamin supplementation is night blindness. In some countries, such as parts of India, night blindness, occurring primarily in late pregnancy, is considered a normal occurrence. The cornea which is the main lens in front of the eye is one of the areas of the eye that can become effected. With pregnancy the cornea can become swollen due to increased water retention. This can lead to changes in shape that can affect your glass prescription. Most of these changes occur later in pregnancy making it unwise to consider a change of glasses at this time. For the same reason it would be unwise to attempt laser refractive surgery during pregnancy. Contact lens intolerance can also be noted at this time. Other changes that can be observed are lowering of the intraocular pressure and lid drooping known as ptosis, usually seen later in pregnancy. The latter problem is thought to be due once again to water retention that stretches the connection of the levator muscle to the lid.
More serious problems occur in those people suffering from preeclampsia and eclampsia. Up to 50% of these people witness visual alteration which can involve diminished sight and/or photopsias such as spots in your field of vision. When this occurs narrowing of blood vessels within the eyes can be observed and in more severe cases can be accompanied with hemorrhages and exudates from these same vessels. These same people can also succumb to cortical blindness meaning that the visual areas of the brain can also become involved. This phenomenon is also usually due to edema or swelling and recovery usually occurs shortly after birth. These reversible changes are also observable with MRI scanning. Patients with known diabetic changes in their retinas need to be examined carefully in pregnancy as these changes can worsen requiring treatment. Luckily those who first develop diabetes in pregnancy never seem to develop retinal damage. We recommend that all women with known diabetes should be screened with a dilated fundus exam before getting pregnant and once again in their first trimester. If free of disease no further follow-up is require for another 12 months.