Pregnancy And Eye Exams: Are Dilated Eye Exams Safe?

Pregnancy can affect a woman's vision in a variety of ways, and it is important to determine whether these changes are temporary or indicative of a more serious problem. It is safe for pregnant women to get their eyes dilated and examined, and doing so can help detect any issues in the back of the eye. While there is a low risk of vision changes during pregnancy, it is still a good idea to consult an eye doctor about any changes.

It is safe to get your eyes dilated while pregnant

Pregnancy is a time of many changes, and that includes changes to your vision. It is safe to get your eyes dilated while pregnant, and it's a good idea to see an eye doctor during pregnancy.

Vision changes during pregnancy

Pregnancy can affect your visual acuity. Some people find that their ability to read or see things up close is affected by pregnancy. These visual changes are usually caused by pregnancy-related swelling of the cornea and will resolve soon after delivery. However, it's always a good idea to get your eyes checked to rule out other problems.

Eye care while pregnant

You can continue to wear contact lenses during pregnancy, and contact lens solutions and enzymatic cleaners are safe to use. However, some women experience dry eyes during pregnancy, which can be uncomfortable when wearing contacts. Lubricating or rewetting eye drops are perfectly safe to use while pregnant or nursing and can help with this discomfort.

Getting new glasses or contacts

Because pregnancy can affect your vision, it's better to wait until after birth to get a new glasses or contact lens prescription. In many cases, people can return to their previous prescription after giving birth. In the meantime, you may only need to get some inexpensive reading glasses.

Pre-existing eye conditions

If you have pre-existing eye conditions, such as glaucoma, high blood pressure, or diabetes, it's important to tell your eye doctor that you are pregnant. Your eye doctor may want to monitor your vision more closely during this time.

Diabetic retinopathy

Pregnant women with pre-existing diabetes, especially type 1, have an increased risk of developing or progressing diabetic retinopathy during pregnancy. The risk may double during pregnancy, especially if retinopathy was present before pregnancy. In these cases, it's important to carefully monitor the patient with frequent dilated eye exams.

Vision changes during pregnancy are temporary

Vision changes during pregnancy are usually temporary. The hormonal and physical changes that come with pregnancy can affect your eyesight, but these changes are typically minor and short-term. Your vision should return to normal after giving birth.

Pregnancy causes fluid retention, which can change the shape or thickness of your corneas, leading to distorted vision. This is usually nothing to worry about, and these changes typically disappear after delivery or after you stop breastfeeding. However, if you wear glasses, you may need to change your prescription. Most eye experts advise against getting LASIK surgery or being fitted for new contact lenses during pregnancy.

During pregnancy, you may also experience dry eyes, which can be irritating if you wear contact lenses. Preservative-free artificial tears can help to ease this dryness.

In rare cases, vision changes during pregnancy can be a sign of a more serious issue, such as gestational diabetes or preeclampsia. If you experience double vision, eye floaters or flashes, partial vision loss or blind spots, or sensitivity to light, contact an eye doctor.

Blurred vision may also be a symptom of a condition affecting your eyes that can worsen during pregnancy, such as diabetic retinopathy, idiopathic intracranial hypertension, multiple sclerosis, or tumours such as pituitary adenomas.

If you are experiencing vision changes during pregnancy, it is important to see your healthcare provider to determine the cause.

Diabetic retinopathy can progress during pregnancy

Diabetic retinopathy (DR) is a common complication of diabetes, affecting around half of all people with the condition. It is a leading cause of visual loss and new-onset blindness in the US for those aged 20 to 74. DR is pre-existing in about 1% of pregnancies in the US, and the condition can progress rapidly during pregnancy, posing potentially devastating consequences for both mother and baby.

Pregnancy is a significant risk factor for the progression of DR. Hormonal and systemic changes can accelerate microvascular damage, and the greatest risk of worsening occurs during the second trimester, persisting for up to 12 months postpartum. The risk factors for progression include the duration of diabetes, the severity of retinopathy at conception, hyperglycaemic control, anaemia, and coexisting hypertension.

As such, it is recommended that diabetic women planning a pregnancy undergo a comprehensive eye examination to detect any signs of DR and establish a baseline level. Once pregnant, close ophthalmic follow-up is necessary, especially for those with a higher-risk form of the disease or rapid progression. Treatment should not be delayed in the hope that DR will regress after delivery, as this may lead to worse outcomes.

While there is a risk of DR worsening during pregnancy, it is important to note that pregnancy does not have any long-term detrimental effects on the retina. DR that progresses during pregnancy tends to regress after delivery, although this is not always the case. Additionally, if the retinopathy is stable after delivery, there is no increased risk of progression with subsequent pregnancies.

In terms of eye examinations during pregnancy, dilation drops are generally considered safe. There is little to no systemic absorption of these drops into the body, and the benefits of dilation, which allows for a more thorough examination of the back of the eye, are thought to outweigh any potential risks. However, some women may still have concerns about the procedure, and alternative screening methods such as Optos retinal screenings are available.

Topical eye drops have a low risk of fetal complications

Topical eye drops are generally considered safe during pregnancy, with only a low risk of fetal complications. This is because only a tiny amount of the medication is absorbed into the body, and the benefits of dilation usually outweigh the risks.

When we use topical eye drops to dilate the eye, there is little to no systemic absorption into the body. The amounts that enter the bloodstream are so minuscule that they are unlikely to cause any adverse effects on the developing fetus. This is especially true when compared to the potential benefits of dilation, which can help detect problems at the back of the eye that would otherwise go unnoticed.

The use of topical eye drops during pregnancy has been studied, and no credible evidence supports the idea that mydriatic (dilating) eye drops have ever caused harm to a developing fetus. While it is true that some medications can cross the placenta and reach the fetus, the amount absorbed through topical eye drops is negligible.

However, it is important to note that the absorption of topical eye drops can be minimized even further by using the correct technique. This includes properly occluding the punctum (the small opening in the corner of the eye where tears drain) and applying nasolacrimal pressure. Additionally, any excess medication should be wiped away to prevent unnecessary exposure.

While the risks of fetal complications from topical eye drops are low, it is always important for pregnant individuals to consult their doctor before using any medication, including eye drops. Open communication between the patient and their doctor is crucial to ensuring safe and effective medical care during pregnancy.

Consult an ob-gyn before initiating treatment on a pregnant patient

Pregnancy is a time of significant physiological changes and increased stress on the body. As such, it is crucial to consult an obstetrician-gynecologist (ob-gyn) before initiating any treatment on a pregnant patient. Here are four to six paragraphs elaborating on this topic:

The Importance of Consultation

Consulting an ob-gyn is essential for ensuring the safety of both the mother and the unborn child. Pregnancy can affect various organ systems in the body, and an ob-gyn is trained to understand and manage these changes. They can assess the risks and benefits of different treatments and make informed decisions.

Shared Decision-Making

The relationship between a pregnant patient and their ob-gyn should be based on shared decision-making. While the ob-gyn can provide medical recommendations, the patient's desires and concerns should also be considered. Open communication and collaboration are key to developing a suitable treatment plan.

Pregnancy-Related Changes

During pregnancy, the body undergoes hormonal, hematological, immunological, and metabolic changes that can impact the eyes. For example, there may be a decrease in corneal sensitivity and a change in refractive index, leading to contact lens intolerance. An ob-gyn can help manage these changes and refer the patient to a suitable eye specialist if needed.

Eye Examinations During Pregnancy

Some pregnant women may be concerned about the safety of eye examinations, particularly those involving dilation. However, there is no credible evidence that dilation eye drops cause adverse effects on the fetus. The benefits of dilation, which allows for a more comprehensive examination, typically outweigh the risks. Nonetheless, alternative screening methods are available for those who prefer to avoid dilation.

Choice of Medication

The choice of medication during pregnancy requires careful consideration. Topical and systemic medications can have different effects on the body, and some may be unsafe for the fetus. For example, certain antibiotics and antivirals should be avoided during pregnancy, while others are generally considered safe. An ob-gyn can guide the selection of medications that are appropriate for pregnant patients.

Specialist Referrals

In some cases, an ob-gyn may refer a pregnant patient to other specialists, such as an ophthalmologist, to address specific concerns. This collaboration ensures that the patient receives comprehensive care that takes into account both their pregnancy and any other health conditions.

Frequently asked questions