The maternal fetal eye- connection: Understanding vision change during pregnancy

Pregnancy brings about numerous changes in a woman’s body, including alterations in vision that can affect both the mother and the developing fetus. Understanding the maternal-fetal eye connection and the potential vision changes during pregnancy is essential for expecting mothers and healthcare providers. Here’s an overview:

Hormonal Changes: During pregnancy, hormonal fluctuations, particularly increases in estrogen and progesterone levels, can affect various ocular structures, leading to changes in vision. These hormonal changes may cause fluctuations in corneal thickness, tear production, and intraocular pressure, contributing to symptoms such as dry eyes, blurred vision, and discomfort.

Refractive Changes: Many women experience temporary changes in their refractive error during pregnancy, often manifesting as myopia (nearsightedness) or astigmatism. These refractive changes are typically attributed to fluid retention, corneal curvature alterations, and changes in lens thickness and shape due to hormonal influences. While these changes are usually reversible postpartum, women may need temporary adjustments to their eyeglass or contact lens prescriptions during pregnancy.

Dry Eye Syndrome: Hormonal fluctuations and changes in tear production can contribute to dry eye syndrome during pregnancy. Symptoms may include itching, burning, redness, and a sensation of grittiness or foreign body in the eyes. Managing dry eye symptoms with lubricating eye drops and maintaining good eyelid hygiene can help alleviate discomfort.

Gestational Diabetes and Vision: Gestational diabetes mellitus (GDM), a form of diabetes that develops during pregnancy, can have implications for maternal eye health and vision. Uncontrolled diabetes can lead to diabetic retinopathy, a potentially sight-threatening complication characterized by damage to the blood vessels in the retina. Women with GDM should undergo regular eye examinations to monitor for signs of diabetic retinopathy and other diabetes-related eye complications.

Preeclampsia and Vision Changes: Preeclampsia, a hypertensive disorder that can occur during pregnancy, may cause vision changes such as blurred vision, photophobia (sensitivity to light), and visual disturbances like floaters or flashes of light. These symptoms may indicate serious complications, including hypertensive retinopathy or central serous chorioretinopathy, and require immediate medical attention.

Fetal Eye Development: The developing fetus’s eyes begin to form early in pregnancy, with the optic vesicles appearing around week 4 and the formation of the retina, lens, and other ocular structures progressing throughout gestation. Maternal health and lifestyle factors, such as nutrition, smoking, alcohol consumption, and exposure to toxins, can influence fetal eye development and vision outcomes.

Postpartum Vision Changes: Vision changes may persist or resolve postpartum, depending on individual factors and the underlying cause. While many women experience a return to pre-pregnancy vision within a few months after delivery, some may continue to experience refractive changes, dry eye symptoms, or other ocular issues requiring ongoing management.

Understanding the maternal-fetal eye connection and the potential vision changes during pregnancy is essential for proactive eye care and optimal maternal and fetal health outcomes. Expecting mothers should prioritize regular eye examinations, maintain good overall health, and promptly report any vision changes or concerns to their healthcare providers for appropriate evaluation and management. By staying informed and proactive, women can safeguard their eye health and ensure the best possible vision outcomes for themselves and their babies during pregnancy and beyond.

(The writer is a Sr. Cornea and Refractive Surgeon, Maxivision Eye Hospital, Somajiguda)