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Written by:  Gina Roberts-Grey
Date: September 1, 2009

Stretch marks and an increased shoe size are expected, but few women realize that pregnancy can impact the way they see the world. In fact, the same hormones that are responsible for your enhanced bust line and first-trimester nausea can cause fluctuations in vision, dry eyes and increased eye irritation.

Vision changes are typical during pregnancy, says Dr. Valerie Kattouf, an associate professor of optometry and spokesperson for the American Optometric Association. Even though every pregnant woman doesn't experience blurriness or need new lenses, many find the hormonal fluctuations can cause a myriad of vision symptoms during pregnancy and throughout nursing, Kattouf says.

Temporary discomfort

According to the American Optometric Association, dry eyes are expectant women's most common eye-related complaint. Dry eyes are caused by fluctuations of estrogen and androgen that decrease the production of natural tears. Symptoms may include dryness, irritation, burning and a gritty feeling.

Dry eyes are troublesome for any mom-to-be, but if you wear contacts, the condition can be especially bothersome. To relieve the discomfort, wear glasses one day and contacts the next; avoid wearing your contacts for extended time periods; and try switching to a different brand of contacts.

Changes in vision

Although most trips to the eye doctor are because of dry eyes, pregnant women also commonly experience thickening of the cornea, the dome-shaped outer layer of the eye that helps you put images in focus, Kattouf says. Retained fluids cause this thickening, which can result in refractive changes like blurred vision.

These changes may occur suddenly, worsen gradually or come on intermittently. Like dry eyes, this alteration in the cornea can make wearing contact lenses uncomfortable.

Depending on when during the pregnancy refractive changes occur, and the severity of the changes, eye doctors may either alter the prescription for contacts or eye glasses or suggest a woman wait until she delivers to make changes, Kattouf says.

This might seem frustrating, but experts recommend you don't make changes to your lenses during the last trimester and for six to nine months after delivery or you stop nursing.

Because hormonal spikes and surges usually drive pregnancy vision issues, you may experience changes at any time during pregnancy, but they usually correct after childbirth. In fact, if your eye doctor does alter your lenses, keep your original contacts or glasses for when your vision returns to its pre-pregnancy state.

Women who experience refractive changes may also find that the blurriness or trouble focusing is sporadic, depending on the amount of water they're retaining. In this case, many doctors might not alter prescriptions, Kattouf says.

More serious complications

Although most pregnancy-related vision issues are not serious, experts caution that significant vision changes can be the first signs of gestational diabetes and high blood pressure.

Diabetics should be seen by an eye doctor at least once per trimester or more, says Janet S. Sunness, M.D., medical director of the Hoover Rehabilitation Services for Low Vision and Blindness at the Greater Baltimore Medical Center.

Women who've been diagnosed with preeclampsia, the next step after gestational hypertension, may also experience blurred vision, see spots, or have decreased or partial vision in one or both eyes. This is due to the increased fluid under the retina, which can actually detach it. Sunness recommends monitoring this during pregnancy, although most problems should reverse after childbirth.

If you lose vision in one or both eyes, whether you have preeclampsia or not, see an eye doctor. These symptoms may be related to the eye or to the brain, Sunness says.

Eye exams when pregnant

Optometrists recommend annual eye exams for anyone older than 18, including pregnant women, Kattouf says. So don't put off going to the eye doctor when you're pregnant, but as long as you keep up with annual exams, you don't have to make a special trip just because you're expecting.

However, if you experience any changes in your vision or eye-related discomfort, including blurriness or dry eyes, Kattouf says you should have your eyes checked, even if it's not time for your yearly exam.

If you visit the eye doctor when pregnant, the exam won't vary much from a typical one. However, you may have to decide whether or not to have your eyes dilated. Although there isn't any evidence dilation causes complications, some women opt not to have their eyes dilated because the drops can be absorbed into the bloodstream.

Dilation is safe during pregnancy, and there is virtually no risk to the mother or unborn child. However, it is not always necessary when examining for dry eyes or minor refractive changes, Sunness says.

She also says that a complete exam of the eye and retina cannot be performed without dilation. If you need dilation and the drops concern you, she suggests putting pressure between the eye and the nose, at the tear duct, which helps block off the passage and prevent the drops from entering the bloodstream.

A new screening technology, Optomap, provides an alternative to dilation. The Optos instrument allows an eye doctor to view most of the retina without dilation. Because this technology is relatively new, it may not be available in all practices and it may not be covered by insurance.

Gina Roberts-Grey is a freelance magazine writer who lives in New York with her husband and son. She started wearing glasses during her pregnancy and decided she liked seeing clearly so much she continued after delivering her son.



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