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Review
. 2014 Aug 18;111(33-34):567-75; quiz 576.
doi: 10.3238/arztebl.2014.0567.

Ocular changes during pregnancy

Friederike Mackensen  1 , Wolfgang E Paulus, Regina Max, Thomas Ness
Affiliations
Review

Ocular changes during pregnancy

Friederike Mackensen et al. Dtsch Arztebl Int. .

Abstract

Background: Most ocular changes in pregnancy are harmless. For example, 14% of pregnant women need a new eyeglass prescription. Some changes, however, are serious, such as retinal effects of hypertension, which can be a sign of pre-eclampsia. Ocular changes may give rise to uncertainty about the administration of ophthalmological drugs or the optimal method of childbirth.

Method: This review is based on pertinent literature retrieved by a selective search in Medline and on guidelines from Germany and abroad. Recommendations about drugs were taken from the Embryotox and Reprotox databases, the German Red List, and the United States Food and Drug Administration (FDA).

Results: 40% to 100% of pregnant women with high blood pressure have retinal changes whose severity is correlated with the severity of pre-eclampsia or eclampsia. Diabetic women should undergo ocular examination before and during pregnancy. Pre-existing retinal changes worsen during pregnancy in 55% of cases. Most ocular diseases can be treated with the usual drugs in pregnant women and nursing mothers, although the evidence for drug safety is derived from case series and the treatment is usually provided off label. Ocular conditions that are present before pregnancy are irrelevant to the choice of a method of childbirth.

Conclusion: Pregnant women and nursing mothers can undergo most types of ophthalmological examination and treatment. Recommendations about drug treatment should be checked against current information that can be found on the embryotox.de and reprotox.de websites.

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Figures

Figure 1
Figure 1
An innocuous conjunctival hemorrhage (hyposphagma, arrow) that was spontaneously resorbed within 2–3 weeks. Such hemorrhages arise in about 11% of pregnancies, usually after delivery.
Figure 2
Figure 2
A typical image by optical coherence tomography (OCT) of central serous chorioretinitis, showing fluid deposition under the retinal layers (arrow).
Figure 3
Figure 3
Hypertensive retinopathy with hemorrhages (solid white arrows), cotton-wool spots (open arrow), and exudates (solid black arrows) in eclampsia.
See this image and copyright information in PMC

Comment in

  • Further specification required.
    Hammes HP. Hammes HP. Dtsch Arztebl Int. 2015 Mar 13;112(11):194. doi: 10.3238/arztebl.2015.0194a. Dtsch Arztebl Int. 2015. PMID: 25837863 Free PMC article. No abstract available.
  • Further specification required. In reply.
    Mackensen F, Ness T. Mackensen F, et al. Dtsch Arztebl Int. 2015 Mar 13;112(11):194. doi: 10.3238/arztebl.2015.0194b. Dtsch Arztebl Int. 2015. PMID: 25837864 Free PMC article. No abstract available.

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