The eye and visual system in pregnancy, what to expect? An in-depth review

Abstract

Pregnancy represents a real challenge to all body systems. Physiological changes can involve any of the body organs including the eye and visual system. The ocular effect of pregnancy involves a wide spectrum of physiologic and pathologic changes. The latter might be presenting for the first time during pregnancy such as corneal melting and corneal ectasia, or an already existing ocular pathologies that are modified by pregnancy such as diabetic retinopathy and glaucoma. In addition, pregnancy can affect vision through systemic disease that are either specific to the pregnant state itself such as the pre-eclampsia/eclampsia and Sheehan's syndrome, or systemic diseases that occur more frequently in relation to pregnancy such as Graves’ disease, idiopathic intracranial hypertension, anti-phospholipid syndrome, and disseminated intravascular coagulation.

Ophthalmic Complications and Ocular Changes in Pregnancy- A Review

“…Glaucoma: Glaucoma is another preexisting disease modified by pregnancy. As mentioned earlier, intraocular pressure is decreased during pregnancy [11][12][13][14][15]. Intraocular pressure decreases during the second trimester and continues to decrease with the advancing pregnancy [13].…”

“…Refractive corneal procedures such as LASIK are contraindicated and should be postponed until refractive changes stabilize in the postpartum. Also, dry eye and decreased corneal sensation could result in significant postoperative complications such as poor wound healing and corneal melt [11]. It is even recommended to delay changing prescription glasses as new lenses are not likely to be suitable once physiological changes resolve in the postpartum.…”

“…Certain systemic diseases such as eclampsia, preeclampsia, and Sheehan syndrome are specific to pregnancy while antiphospholipid antibody syndrome (APS), benign intracranial hypertension, Graves' disease, and disseminated intravascular coagulation (DIC) have an increased frequency in pregnancy [11,16].…”

“…The choroid is the most common intraocular structure involved during DIC [11,38]. Increased thrombus formation most commonly leads to vascular obstruction within the choroid, specifically the choriocapillaris.…”

“…Disseminated Intravascular Coagulation (DIC) is known to be a complication of pregnancy secondary to common obstetric causes including: amniotic fluid embolism, intrauterine fetal demise (IUFD), preeclampsia/eclampsia, placental abruption, placenta praevia, septic abortion, intrauterine infection, and acute fatty liver of pregnancy [11,[35][36][37].…”