Ocular changes in pregnancy

Visual changes in pregnancy are common, and many are specifically associated with the pregnancy itself. Serous retinal detachments and blindness occur more frequently during preeclampsia and often subside postpartum. Pregnant women are at increased risk for the progression of preexisting proliferative diabetic retinopathy, and diabetic women should see an ophthalmologist before pregnancy or early in the first trimester. The results of refractive eye surgery before, during, or immediately after pregnancy are unpredictable, and refractive surgery should be postponed until there is a stable postpartum refraction. A decreased tolerance to contact lenses also is common during pregnancy; therefore, it is advisable to fit contact lenses postpartum. Furthermore, pregnancy is associated with a decreased intraocular pressure in healthy eyes, and the effects of glaucoma medications on the fetus and breast-fed infant are largely unknown.