December 7, 2021

By Emeline Mugisha, MSN, MPH, RN

Along with the more well-known ways that pregnancy affects your body, many others may come as a surprise, such as pregnancy's impact on your eyes. In fact, visual symptoms during pregnancy are common and almost always harmless. Occasionally, however, symptoms may be severe and require immediate referral to an eye specialist. To help keep you and your baby safe, it’s important to be aware of the various eye concerns you might encounter during pregnancy and share any vision changes you experience with your medical provider.

How does pregnancy affect your eyes?

All structures in and around the eye can experience changes during pregnancy, leading to visual symptoms. Like all body systems, these changes can be physiological or pathological. Physiological changes are normal. Pathological changes occur when an illness is present.

During pregnancy, physiological changes take place when your body releases hormones to support your baby’s growth and prepare you for birth. These hormones have an impact on all organ systems, including your eyes. In addition to hormonal changes, pregnancy’s impact on blood circulation, metabolism, water retention, and the immune system can affect your eyes.

Pathological complications of the eye can develop due to pregnancy-specific diseases (such as preeclampsia and eclampsia), or pregnancy’s impact on existing diseases (such as diabetes).

Thankfully, most pregnancy-related eye changes are due to normal maternal physiology. They tend to occur in the surface of your eye, the cornea, as well as the structures that surround and support your eye (such as your eyelids and tear glands). These changes are usually mild, temporary, and require no treatment, but may become permanent in rare cases.

One of the most common pregnancy-related physiological changes is the darkening of the skin around the eyelids (also known as “pregnancy mask,” chloasma, or melasma).

Many pregnant women also experience dry eyes because the eyes produce fewer tears during pregnancy. This change can make your eyes feel uncomfortable, and sometimes it can cause vision problems. Symptoms of dry eye (also known as dry eye syndrome) may include:

• A burning, itching, or dry feeling in your eye
• A gritty feeling, like there's something stuck in your eye
• Sore eyes
• Red eyes
• Blurry vision
• Light sensitivity

Additionally, increased water retention may increase the shape and thickness of your cornea later in pregnancy. Along with the decline in tear production, these corneal changes can make it especially difficult or uncomfortable for some women to wear contact lenses.

When do vision changes require medical attention?

Because it’s hard to know if eye symptoms are normal or not, it’s important to tell your medical provider if you experience any vision problems while you’re pregnant. Certain symptoms that may seem harmless (for example, a persistent dry eye with discomfort or pain) require evaluation by an eye specialist to reduce the risk of infection, scarring, or permanent injury.

Symptoms that require immediate medical attention include but are not limited to:

• Eye pain
• Vision loss
• Double vision
• Light sensitivity
• Flashes of light
• Any sudden changes in your vision

Although most vision changes in pregnancy are harmless, changes that involve the retina can be a sign of more serious eye disease (such as diabetic retinopathy or preeclampsia).

The retina is a vital tissue at the back of your eye that works with your brain so you can see. Retinopathy is any disease that involves damage to the retina.

Diabetic retinopathy is the most common eye disease that worsens in pregnancy and is usually a complication of type 1 diabetes. Studies show that the risk of retinopathy is low among pregnant women with type 2 diabetes, and it's very low in women with gestational diabetes.

If you have any concerns about your eyes or vision in pregnancy, it’s a good idea to speak with your medical provider to help put you at ease as you encounter these changes.

Will the vision changes disappear after pregnancy?

Yes, most vision changes in pregnancy resolve postpartum, usually within a few weeks after delivery or breastfeeding. For this reason, it’s often not necessary to change your contact lens or eyeglass prescription until after your baby is born or you’re no longer breastfeeding.

Sources:

Cheung, A., & Scott, I. U. (2016, February 17). Ocular changes during pregnancy. American Academy of Ophthalmology. https://www.aao.org/eyenet/article/ocular-changes-during-pregnancy

Gotovac, M., Kastelan, S., & Lukenda, A. (2013). Eye and pregnancy. Collegium Antropologicum, 37, Suppl 1: 189-193.

Samra K. A. (2013). The eye and visual system in pregnancy, what to expect? An in-depth review. Oman Journal of Ophthalmology, 6(2), 87-91. https://doi.org/10.4103/0974-620X.116626

Yenerel, N. M., & Küçümen, R. B. (2015). Pregnancy and the eye. Turkish Journal of Ophthalmology, 45(5), 213-219. https://doi.org/10.4274/tjo.43815



Emeline Mugisha, MSN, MPH, RN - Emeline Mugisha is an award-winning, master's-prepared nurse with over a decade of experience in community/public health and clinical health services at the field and management levels. She has co-authored two professional manuscripts in Women's Health Issues and the Journal of Midwifery and Women's Health. She has an M.S. in Public Health Nursing and an M.P.H. from Johns Hopkins University.