Hormonal fluctuations during pregnancy can trigger both physiological and pathological changes in the eye, making it crucial for eye care providers to monitor patients well into the post-delivery period, according to a recent literature review published in Clinical and Experimental Optometry.
The review, led by Dr. Bao N. Nguyen, PhD, a senior researcher in optometry and vision sciences at the University of Melbourne, delves into the pregnancy-related effects on eye health and vision, highlighting their significance for routine eye care. The research team examined articles published since 1993, focusing on pregnancy and ocular health, including various eye-related conditions.
Nguyen emphasized the importance of understanding the timing and nature of these pregnancy-related changes. “What is particularly important for routine pregnancy eye care is knowledge of the timing of uncomplicated pregnancy-related changes,” Nguyen explained. “This includes understanding when they occur during gestation, their peak times, and whether these changes are temporary or may extend beyond pregnancy.”
The study revealed that hormonal shifts during pregnancy significantly influence ocular functions, such as tear production, ocular surface health, and cell and nerve regeneration. Key hormones like relaxin and human chorionic gonadotropin peak during the first trimester, while estrogen, progesterone, prolactin, and oxytocin reach their highest levels in the third trimester.
Throughout the pregnancy, several eye changes were noted. During the first trimester, women experienced melasma and an increase in the choroidal luminal area. The second trimester saw an increase in corneal thickness and curvature, a reduction in intraocular pressure (IOP), and a higher incidence of central serous chorioretinopathy, alongside worsened diabetic retinopathy in patients with preexisting diabetes. By the third trimester, there was a noticeable increase in retinal and choroidal thickness, as well as a growing prevalence of dry eye disease as pregnancy progressed.
While most physiological eye changes typically resolve in the post-partum period, the review found that pathological changes—either newly onset or aggravated by pregnancy—could persist for weeks or even months after delivery.
The researchers suggest that primary eye care professionals play an essential role in monitoring women well into the post-partum phase, well beyond the typical post-pregnancy health follow-up. “Some eye-related effects can last for years after pregnancy ends, so there is a need for continuous care,” Nguyen noted. “Women currently or previously pregnant, as well as healthcare providers, should be educated about the importance of seeking eye care before, during, and after pregnancy.”
This study underscores the importance of ongoing eye care to address the long-term ocular effects of pregnancy and to ensure better vision health for mothers even after delivery.
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