Pregnancy and vision: what is worth knowing so as not to be afraid or miss the danger

There are many myths that pregnancy can lead to impaired vision, and childbirth can lead to its loss. Therefore, women who have poor eyesight prepare themselves in advance for a cesarean section. Is that so? Tatiana Petrovskaya, an ophthalmic surgeon and chief physician of the Novy Zir clinic, will talk about the most common fears and real threats.

Source: freepik

Tatiana Petrovskaya

Ophthalmologist, chief physician of the clinic “Novyi Zir”

The biggest misconceptions

In fact, women with refractive errors (myopia, farsightedness) can give birth on their own. In general, myopia, even of the highest degrees, is not an indication for cesarean section. After all, during the normal course of pregnancy and childbirth, there are no mechanisms that could lead to vision loss with myopia.

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When an operative method of childbirth is necessary

There are very few ophthalmological indications for such an intervention. According to the unified clinical protocol "Caesarean section", approved by the Ministry of Health in 2022, there are only 4 reasons for this:

• hemorrhagic retinopathy — a disease of the retina accompanied by intraocular hemorrhages;
• open eye injuries in which the integrity of the eyeball is broken;
• an acute attack of glaucoma, when the intraocular pressure suddenly and significantly increases;
• perforated corneal ulcer is a severe inflammation in which the cornea thins and tears.

Fortunately, these problems happen very rarely. So a regular pregnant woman does not need a caesarean section!

Is it necessary to undergo an eye examination?

When planning a pregnancy, it is necessary to take into account not only the general state of the body, but also the health of the eyes. When a woman is placed under obstetric care, the doctor refers her to specialists, including an ophthalmologist. Such an examination allows you to identify problems and understand whether there are risks during pregnancy and childbirth. The ophthalmologist will provide the future mother with recommendations in accordance with her condition. These may be lifestyle advice, and in the case of disease diagnosis, prescribed treatment.

Women who have certain somatic diseases require special attention. For example, diabetes mellitus, because during pregnancy it can develop quite aggressively. And diabetic eye complications are dangerous because they lead to serious vision problems. An ophthalmologist examines such patients in the first and second half of pregnancy, and after childbirth. It is precisely these women (if they have severe complications from the retina, in particular diabetic) that sometimes require a caesarean section, as well as specialized ophthalmological treatment.

Source: freepik

For those who use lenses

If you have poor eyesight and wear contact lenses, you need to take care of the selection of glasses. The fact is that during pregnancy, the hormonal background changes — such a hormone as progesterone is activated. Because of this, changes can occur in the cornea — the eye shell on which lenses are worn. As a result, their poor tolerance appears. Therefore, there should be glasses in case the woman cannot use lenses.

This is also an important nuance for a woman in labor. After all, in the middle of the night, the mother has to get up to the child, and she must see well without lenses. A woman's lifestyle and daily regime change, so glasses will come in handy in any case.

Can vision fall during pregnancy and childbirth?

This rarely happens. The most common reason is a change in eye refraction. In other words, myopia may develop or progress. Usually these phenomena are temporary, as they are associated with changes in the cornea and lens due to the hormonal background of pregnancy. As noted above, they are caused by the action of progesterone and disappear after childbirth. Vision is restored with the birth of a child, most often completely or partially.

However, if myopia has increased, it is necessary to visit an ophthalmologist to know whether you have sufficient vision. In this case, it will be necessary to replace glasses or select temporary ones, if they were not there before pregnancy.

A woman in a position for various reasons can limit physical activity on the street and spend a lot of time on gadgets. These are factors that provoke a violation of accommodation (vision of distant and near objects) and the appearance or progression of already existing myopia, as well as dry eyes. The so-called "computer syndrome" arises. That's why you need to take care of your regime, don't overload your body with screen time and walk more in the fresh air.

Source: freepik

Autoimmune diseases

Often, in women with autoimmune diseases, pregnancy causes an increase in immune tolerance, so their condition may, on the contrary, temporarily improve. But here you have to be vigilant and keep in mind that after giving birth, the probability of disease exacerbation increases. Thus, in the case of multiple sclerosis after childbirth, neuritis (inflammation) of the optic nerve may develop against the background of the disease. Then the mother's vision deteriorates sharply and pain occurs when the eye moves.

However, usually women know about their autoimmune conditions, or they are diagnosed during a medical examination, when they are registered. Therefore, they should be aware that a temporary improvement during pregnancy may turn into an aggravation after childbirth. This also applies to eye problems. Sometimes immediate treatment is necessary, so you need to focus not only on the baby, but also be attentive to your health.

Preeclampsia

Complicated pregnancy can cause vision-threatening conditions, in particular with gestosis (it used to be called toxicosis). In the case of preeclampsia, when the function of the kidneys is disturbed and blood pressure rises significantly, eye disorders are also possible, up to retinal detachment. If other causes of vision loss are excluded, such a disease usually does not require treatment by an ophthalmologist, so obstetricians and gynecologists should deal with the woman. Of course, a decision can be made about cesarean section, but not because of vision impairment, but because of preeclampsia. The retina will then fall into place, so no specific treatment is needed.

Source: freepik

algorithm

Regarding the eyes, there can be different mournings - flashes of light, split images, decreased vision up to complete ego loss. When such symptoms appear in a woman, she should urgently contact her gynecologist. If he does not find an explanation from the side of the obstetric condition, then an ophthalmological examination will be needed.

In connection with pregnancy, it is rare, but there are disorders of cerebral blood circulation, respectively, and disorders of blood circulation in the retina. Hormonal changes can accelerate the growth of tumors of the brain and orbits. Such conditions threaten vision, so they require separate examination and treatment.

To summarize, it is best for a woman to do a comprehensive examination of her body at the stage of pregnancy planning, or at least when registering, in the early stages, in order to rule out risks in the later period. And remember about dangerous symptoms (decreased vision, flashes before the eyes, flies, bifurcation), which require immediate attention and a visit to the doctor.

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