Pregnant? What happens to your eyes?

Just another symptom from what to expect when you are expecting! or should I say not expecting?!

Yes, your eyes do go through some changes whilst pregnant. While most are non-concerning and temporary, a few are more significant and require a little more care.

Blurry Eyes

You may have already noticed, your vision might have turned blurry or more sensitive to light and glare. You might also find your glasses aren’t as good as they used to be, nor are you tolerating contact lens wear.

These changes may simply be attributed to dry eyes. Pregnant or not, dry-eye prevalence is on the increase for whatever reason you can think of. Being pregnant is just another risk of dry-eyes. And with it, comes light sensitivity, redness, sandy sensation, itchiness and watery eyes.

Learn more about dry-eyes

Another reason for blurry vision is the swelling of the cornea. Just as your body is retaining more fluid in the legs, feet and hands; the cornea isn’t spared. For the same reason, you may notice swollen lids and puffy eyes. Blame the baby or the hormones, its up to you!

Keratoconus

Keratoconus is a slowly progressive, genetic condition appearing in adolescence that causes a normally dome shaped cornea to thin out and become more cone-shaped. Patients with keratoconus usually have high degrees of irregular astigmatism, requiring high prescription. They are greatly light sensitive and experience significantly blurred vision. Unfortunately, pregnant women with pre-existing keratoconus and swollen corneas will notice worsened state of the condition.

Gestational Diabetes

Gestational diabetes occurs due to difficulty of the body to maintain blood sugar levels. Women with gestational diabetes are more likely to experience pregnancy-related vision problems such as dry eyes and corneal swelling. Also, they are at higher risk of developing pre-clampsia, subsequently its associated vision/eye changes. Fortunately, symptoms may resolve postpartum and the conditions can be effectively monitored and managed with medications.

Preclampsia Related Retinopathy

Preclampsia is a serious pregnancy complication resulting from increases in blood pressure. It occurs in 2-8% pf worldwide pregnancies. 30% of women with preclampsia are likely to develop retinal related complications. The greater the severity of pre-calmpsia, the greater the ocular impact. Symptoms include blurry vision, double vision, light sensitivity and/or changes in the visual field such as scotomas or missing areas. Retinal arteries may narrow and result in bleeding causing retinal hemorrhages and swelling. Secondary vitreous hemorrhage is also possible.

Pregnant women experiencing such symptoms as floating dark spots, gaps in the visual field, side-flashes or curtain-like falling over vision are urged to seek emergency care. Pre-clampsia can be managed with medications and ocular symptoms subside once the pre-clampsia is treated.

Idiopathic Intracranial Hypertension (IIH)

IIH is a condition resulting from increased pressure in the brain. It commonly occurs in Young obese females with characterising symptoms of headaches, pain behind the eyes, reduced vision, reduced peripheral vision, ringing of the ears and nausea or dizziness. pregnancy is a risk factor for IIH, where the condition manifests in the first trimester. Pregnant women should seek urgent care to prevent escalation of symptoms.

Graves Disease and Thyroid Eye Disease

Graves’ disease is an immune system disorder that results in the overproduction of thyroid hormones. The condition exacerbates in the first trimester, rsettles in the second and third trimesters, and relapses postpartum. Opposite to thyroid eye disease where the eye bulges forward, Graves disease is characterised by lid lags. Similar to the previous conditions, ocular graves needs to be monitored and treated.

Pre-existing Eye Conditions

While most eye conditions resolve postpartum, some pre-existing eye conditions such as glaucoma and uveitis improve during pregnancy. Other, like keratoconus, diabetic retinopathy or pituitary tumours may progressively worsen.