This review provides information on the features, incidence, pathogenetic mechanism, possibilities of conservative, laser and surgical treatment of glaucoma in pregnant women. The purpose of this literature review is to study the features of managing patients with glaucoma during pregnancy. Glaucoma is a large group of eye diseases characterized by a gradual development of visual impairments and atrophy of the optic nerve. The pathology is most common among the population over 40 years old, but due to the advancement of reproductive technologies, the availability of diagnostic methods, as well as high clinical awareness, the frequency of ophthalmologists managing glaucoma in pregnant women increases. Elevated intraocular pressure in pregnant women is becoming more common and, therefore, is an urgent problem. There is a trend towards an increase in the number of pregnant women who experienced elevated intraocular pressure for the first time. Previously identified pathology in childhood or secondary glaucoma due to previous ophthalmic diseases or severe somatic pathology is a special category of patients. Such patients are encountered regularly and require close supervision by both an ophthalmologist and a gynecologist. The evidence base for antiglaucoma drugs is small; there are clinical experiments on animals, which results do not always carry over to humans, and retrospective studies. The doctor's arsenal presently includes a number of drugs that have possible side effects for the fetus, as well as laser and surgical treatment. There is no standard treatment, so each case should be considered individually with an understanding of the physiology, mechanism of action of the drugs and their possible effects. Therefore, glaucoma during pregnancy and lactation is a serious medical problem, and its solution depends on interdisciplinary medical approach.
The article presents three clinical cases of severe pathologies of the anterior segment of the eye, which developed in patients with serious concomitant somatic diseases and COVID-19 under the pandemic. Our observations show that the SARS-CoV-2 virus can contribute to the onset of severe keratitis and keratouveitis, characterized by a long torpid course, relapses, and a poorly predicted outcome. In patients with coronavirus and severe somatic pathology, these diseases have atypical symptoms that complicate the diagnosis, are resistant to treatment, and require an extended period of convalescence. This can be explained by pronounced vascular inflammatory reactions, a possible invasion of eye tissue by viral particles, disruption of tear production, a decrease in local immune defense factors of the eye and systemic immunity, and a violation of the hemato-ophthalmic barrier. Local and general drug treatment brought weakly positive changes. The course of the disease took an undulating character. The description of the clinical cases reflects the polymorphism of symptoms and the multiorganic character of damages associated with COVID-19.
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