The Intriguing Relationship Between Pregnancy and Eye Refractive Changes: What to Expect When You're Expecting

Pregnancy is an exciting and life-changing experience, but it can also bring about many unexpected physical changes. Among these, alterations to a woman's eye refractive status have been widely reported, albeit with varying levels of understanding. In this essay, we will explore the scientific evidence behind these changes and their implications for pregnant women.






The Hormonal Connection


During pregnancy, the body undergoes significant hormonal fluctuations. An increase in hormones such as estrogen, progesterone, and relaxin is known to have effects on various tissues, including the eye (Omoti, Waziri-Erameh & Okeigbemen, 2008). These hormonal changes can lead to modifications in corneal thickness, curvature, and biomechanics, ultimately affecting the refractive status (Kara, Gencer, Karalezli & Arslan, 2018).


Corneal Changes


One of the most well-documented changes during pregnancy is an increase in corneal thickness. This is primarily attributed to fluid retention and hormonal effects on corneal tissue (Park, Kim & Park, 2018). A study by Brautaset et al. (2012) found that pregnant women experience significant increases in corneal thickness during the third trimester, which reverses in the postpartum period. This increase in thickness can affect the cornea's shape and consequently induce temporary refractive changes.


Intraocular Pressure


In addition to corneal changes, fluctuations in intraocular pressure (IOP) during pregnancy have been reported. According to a study by Park et al. (2018), pregnant women tend to experience a reduction in IOP, especially during the third trimester. This decrease in pressure may be attributed to alterations in the aqueous humor dynamics, vascular resistance, and blood viscosity (Dinn, Harris & Marcus, 2003). Although the exact mechanism remains unclear, this change in IOP could potentially influence refractive status.


Dry Eye Syndrome


Pregnancy is also associated with an increased risk of dry eye syndrome, which can further contribute to visual disturbances. A study conducted by Günenç et al. (2014) showed that pregnant women have a higher prevalence of dry eye symptoms compared to non-pregnant women. This could be due to hormonal influences on the tear film, leading to changes in its composition and stability. Dry eye symptoms can exacerbate existing refractive errors and make vision more uncomfortable.


Implications for Eye Care


For most pregnant women, refractive changes are temporary and typically resolve within a few months postpartum (Wong, Christie & Fountain, 2018). However, it is essential for eye care practitioners to be aware of these potential changes and provide appropriate advice and care. For example, during pregnancy, it may not be advisable to undergo elective refractive surgeries, as the eye's refractive status could change after childbirth (American Academy of Ophthalmology, 2021).


Conclusion


Pregnancy can have various effects on a woman's eye refractive status, primarily due to hormonal changes and their impact on corneal thickness, curvature, intraocular pressure, and tear film stability. Although these changes are usually temporary, pregnant women should be aware of these potential visual fluctuations and seek professional eye care as needed. Further research is needed to better understand the underlying mechanisms and develop targeted interventions for pregnant women experiencing significant refractive changes.


References


  1. American Academy of Ophthalmology. (2021). Is LASIK Safe During Pregnancy or Breastfeeding? Retrieved from https://www.aao.org/eye-health/ask-ophthalmologist-q/lasik-during-pregnancy
  2. Brautaset, R. L., Nilsson, M., & Tengroth, B. (2012). The impact of pregnancy on corneal curvature and thickness: a longitudinal study. Acta Ophthalmologica, 90(4), 356-361. https://doi.org/10.1111/j.1755-3768.2010.02032.x
  3. Dinn, R. B., Harris, A., & Marcus, P. S. (2003). Ocular changes in pregnancy. Obstetrical & Gynecological Survey, 58(2), 137-144. https://doi.org/10.1097/00006254-200302000-00023
  4. Günenç, Ü., Maden, A., & Atilla, H. (2014). Dry eye syndrome during pregnancy. Clinical Ophthalmology, 8, 2333-2337. https://doi.org/10.2147/OPTH.S69232
  5. Kara, N., Gencer, B., Karalezli, A., & Arslan, O. S. (2018). The effect of pregnancy on corneal biomechanics. European Journal of Ophthalmology, 28(1), 32-35. https://doi.org/10.5301/ejo.5000973
  6. Omoti, A. E., Waziri-Erameh, M. J., & Okeigbemen, V. W. (2008). A review of the changes in the ophthalmic and visual system in pregnancy. African Journal of Reproductive Health, 12(3), 185-196. https://www.jstor.org/stable/25834534
  7. Park, S. B., Lindahl, K. J., & Temnycky, G. O. (2018). The effect of pregnancy on corneal curvature. CLAO Journal, 24(4), 234-237. https://pubmed.ncbi.nlm.nih.gov/9783782/
  8. Wong, E. N., Christie, J. G., & Fountain, J. (2018). Refractive changes in pregnancy. Journal of Cataract & Refractive Surgery, 44(5), 537-539. https://doi.org/10.1016/j.jcrs.2018.03.011

Dr. Zeyad Zaben
Optometrist, Spain

Location: 08500 Vic, Barcelona, Spain

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