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Pregnancy and the Eyes

Eye Health
By Dr S.S. Gill
Ipoh Echo’s Eye Health Series continues with Consultant Eye Surgeon Dr S.S. Gill talking to us about the eyes in pregnancy.
A woman having a baby on board does more than just increase her belly! Pregnancy obviously results in many physiological changes to a woman’s body including the eyes. Let’s take a look at some of the normal physiological changes that occur in a pregnant woman’s eyes that may cause the following to happen:
Decreased Contact Lens Tolerance
If you are a contact lens wearer and become pregnant, do not be surprised if you find that the contact lenses that you have been wearing for umpteen years become difficult to wear comfortably during pregnancy. This is because the cornea (the outermost transparent part of the eye) becomes swollen (oedematous). The swollen cornea therefore becomes thicker with a change in the curvature of the cornea. This usually occurs in the third trimester of pregnancy.
Contact lens wear therefore becomes uncomfortable and some pregnant women may have to abandon wearing their contact lenses temporarily. The eyes also become more dry and this further aggravates the intolerance to contact lens wear often pushing the expectant mother to start wearing her glasses.
The sensation that you are not seeing as clearly as you normally do with your regular contact lenses or spectacles may be the other symptom caused by the swelling of the cornea. It is important not rush off to make a new pair of spectacles during this time as things will usually revert to normal after delivery. This is also NOT the time to go and do Lasik, which is a contraindication during pregnancy.
Some pregnant women have difficulties in accommodation of the eyes and so have some difficulty in reading. Fortunately this is a short-lived problem!
Eye Pressure – Effects on Glaucoma Patients
The eye pressure in a pregnant woman reduces due to the hormonal changes. This is certainly good news for patients who suffer from glaucoma! The hormonal changes increase the aqueous (fluid in the eye) outflow and partly decreases the rigidity of the sclera (the wall of the eyeball). The reduction in eye pressure may last for several weeks after delivery and of course helps in glaucoma patients.
If you suffer from glaucoma, do not be surprised if the eye doctor adjusts your glaucoma medication or eye drops to control the eye pressure. Unfortunately, this beneficial effect does not last very long after delivery.
Changes In Skin Around The Eye
The skin around the eyes and cheeks usually get hyperpigmented and this is called chloasma (picture on the right). It may also occur on the forehead and nose. This is sometimes referred to as “mask of pregnancy”. It is nothing but a hyperpigmentation of the skin that occurs on the face due to hormonal changes.
The other thing that may happen in some pregnant women is a droopy eyelid in one eye. This is called ptosis. The muscle of the eyelid called the levator aponeurosis may develop defects due to pockets of fluid collection. This may cause the eyelid to droop.   As with other effects of pregnancy, it will resolve after a few weeks of delivery.

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