Changes in the eye during pregnancy

Researchers from the University of Melbourne, Monash University and the University of Tasmania have outlined the diverse ways that pregnancy affects the eye.

Writing in Clinical and Experimental Optometry, the Australian scientists highlighted that while many ocular changes during pregnancy are temporary, there are some alterations that persist postpartum.

The narrative review explored the effect of pregnancy on different physical structures in the eye, including the eyelids, tear film, cornea, lens, retina and choroid.

The authors highlighted that melasma – characterised by patches of increased pigmentation around the eye and eyelids – can occur during pregnancy, with onset most common in the first or second trimester.

The authors noted that several studies have also reported lower tear production during pregnancy. Studies have also observed an association between pregnancy and an increased corneal thickness and curvature.

The authors shared that water retention during pregnancy has been suggested by some researchers as an explanation for myopic shift in refractive error.

Reduced intraocular pressure, particularly during the second and third trimesters of pregnancy, is a consistent finding across different studies, the researchers highlighted.

The authors provide an overview of different pathological conditions that have been reported to develop during pregnancy, including corneal thinning, idiopathic intracranial hypertension, central serous chorioretinopathy and ischaemia.

They also outline conditions that can be exacerbated by the onset of pregnancy, including diabetic retinopathy, keratoconus and dry eye disease.

The researchers shared that there is a “notable absence” of scientific literature relating to pregnancy loss and the eye.

“Whether pregnancy-related effects on the eye persist with miscarriage or termination, and for how long, remain unanswered questions,” the authors observed.

They highlighted the need for people planning on becoming pregnant – and healthcare professionals – to receive information about the importance of seeking eye care before, during and after pregnancy.