September October 2021 web

MOTHER’S EYES
DURING PREGNANCY
by James Wymore, MD Eye Surgeons Associates
Pregnancy may have a
variety of effects on the eyes
and eyelids. Fortunately, most
women experience no significant
problems. Of those that do occur,
some are related to physiologic
changes and usually transient.
Others may be associated with
pre-existing diseases, or pregnancy may prompt
new medical diagnoses. The following are some
of the more common.
Chloasma is a blotchy browning (pregnancy
mask) that will sometimes affect eyelid skin. It
tends to fade after delivery. The lids may also
become swollen and droopy, probably from
fluid retention. Spider angiomas, small dilated
blood vessels, may arise on the lids as they do
elsewhere.
Corneal (window of the eye) sensitivity
decreases during pregnancy, mostly in the third
trimester. The corneal curvature may change
as well, even with breast feeding, though some
studies disagree on this point. Both are thought
to be due to corneal swelling. This may cause
contact lens wearers to be more susceptible to
damage from their contacts, and are also a reason
to delay contact lens fitting or glasses change
for at least six weeks postpartum. Eventually
the changes reverse. Consult an eye doctor if
you experience irritation or pain while wearing
contacts. Lasik surgery, which is performed on
the cornea, is not a good idea, either during or
soon after pregnancy and delivery.
Other temporary differences include
decreased eye pressure, dry eyes, and increased
light sensitivity with migraines. Eye pressure is
generally raised in glaucoma, and thus is monitored
to prevent worsening damage. Pressure checks
during pregnancy may not be reliable, so watch
it closely. It’s important to use as little glaucoma
medication as possible, as the effects on the fetus
are not fully known. Treat dry eyes with over the
counter artificial tears. Use of sunglasses is a
good temporary solution for migraine sensitivity
to bright lights.
Because diabetes is common, the effects
of diabetes on the eyes are the most frequently
encountered eye changes in pregnancy. A
significant percentage of women may either
develop diabetic retinopathy (leaking blood
6 September/October 2021 I QC Family Focus