Pregnancy and Eye Changes or Emergencies
How Pregnancy Affects Your Eyes
Pregnancy triggers major hormonal and circulatory changes throughout your body, and your eyes are no exception. Fluid retention alters the shape and thickness of your cornea (the clear front surface of the eye), which can shift your glasses or contact lens prescription. A 2022 report from AAO EyeNet confirmed that these changes also decrease tear production, leaving many pregnant women with dry, irritated eyes.
Most of these changes reverse after delivery. However, some eye symptoms during pregnancy signal serious medical conditions that need urgent treatment. Knowing which changes are harmless and which are warning signs helps you protect both your health and your baby's health.
Many pregnant women notice mild blurriness, especially during the second and third trimesters. Contact lenses that fit well before pregnancy may feel uncomfortable or move around on the eye. Some women experience fluctuating vision that shifts from day to day as fluid levels change.
These refractive changes are usually temporary. Eye doctors often recommend waiting until several weeks after delivery, or after you finish breastfeeding, before updating your glasses or contact lens prescription.
Hormonal changes reduce the quantity and quality of your tears. You may feel grittiness, burning, or a sandy sensation. Your eyes may water more as a reflex response to the dryness. Preservative-free artificial tears are safe to use during pregnancy and can provide relief.
If dry eye symptoms become severe or are accompanied by pain, redness, or light sensitivity, see your eye doctor. These additional symptoms may point to a corneal problem or inflammation rather than simple dryness.
Serious Eye Conditions Linked to Pregnancy
Preeclampsia is a pregnancy complication marked by high blood pressure and protein in the urine, typically developing after 20 weeks of pregnancy. It affects 3 to 5% of pregnanciesworldwide. According to AAO EyeNet and EyeWiki, roughly 25 to 33% of women with preeclampsiadevelop eye-related complications, and that number climbs to 50% in women with eclampsia(the more severe form involving seizures).
Eye symptoms of preeclampsia include blurred vision, seeing spots or flashing lights, temporary loss of vision, and sensitivity to light. These symptoms mean the condition is becoming severe. Report them to your obstetric care team right away, as they may indicate the need for immediate delivery.
In serous retinal detachment, fluid collects beneath the retina and separates it from the tissue behind it. This is different from the more common type of retinal detachment caused by a tear. Preeclampsia causes serous retinal detachment in 1 to 2% of cases, and that rate rises to up to 10% in eclampsia, according to AAO EyeNet.
Women with HELLP syndrome (a severe form of preeclampsia that damages the liver and blood cells) are roughly 7 times more likely to develop retinal detachment, as reported in PMC. that most pregnancy-related serous retinal detachments resolve on their own after delivery. Your eye doctor will monitor your retina during recovery.
Central serous chorioretinopathy (CSC) occurs when fluid leaks under the macula (the part of the retina responsible for central, detailed vision). Pregnancy has a strong association with CSC, especially during the third trimester. A 2017 PMC study found that CSC accounted for 22.4% of acute visual disturbance diagnoses in pregnant patients.
Symptoms of CSC include a dark or blurry spot in the center of your vision, objects appearing smaller or farther away than they are, and straight lines looking wavy. Most cases resolve within a few months after delivery without treatment.
Pregnancy is a hypercoagulable state, meaning your blood clots more easily than normal. This natural change protects against excessive bleeding during delivery, but it also increases the risk of blood vessel blockages in the retina. Retinal artery occlusions (blockages in the arteries feeding the retina) and retinal vein occlusions (blockages in the veins draining the retina) can cause sudden, painless vision loss in one eye.
If you experience sudden vision loss during pregnancy, seek emergency eye care the same day. A retinal artery occlusion is a time-sensitive emergency where early treatment may help preserve some vision.
Women who have diabetes before becoming pregnant face a real risk of their diabetic retinopathy (damage to retinal blood vessels caused by diabetes) getting worse during pregnancy. The hormonal changes, increased blood volume, and blood sugar fluctuations of pregnancy can accelerate retinal damage.
The AAO recommends that women with pre-existing diabetes have a baseline dilated eye exam during the first trimester. Your eye doctor will then schedule follow-up exams throughout the pregnancy to monitor your retina. Women who develop gestational diabetes (diabetes that starts during pregnancy) have a much lower risk and do not typically need additional eye screening.
Warning Signs That Need Urgent Attention
Contact your obstetric care team or go to the emergency room if you experience any of these eye symptoms during pregnancy:
- Sudden loss of vision in one or both eyes
- Flashing lights or a shower of new floaters
- A dark curtain or shadow moving across your vision
- Double vision
- Severe headache combined with blurred vision
The blood vessels in your retina are the only blood vessels in your body that a doctor can observe directly. Changes in these vessels often mirror what is happening in blood vessels throughout your body, including in the placenta. Swelling, narrowing, or bleeding in retinal vessels during pregnancy can be an early sign that preeclampsia or another systemic condition is developing.
This is why your obstetric team takes eye symptoms seriously. A complaint of blurry vision or seeing spots during a prenatal visit may prompt blood pressure checks, lab work, and a referral for a dilated eye exam.
Managing eye conditions during pregnancy often requires teamwork between your obstetrician and your eye doctor. Your obstetrician manages blood pressure, medications, and delivery timing, while your eye doctor monitors the retina and treats eye-specific complications. Make sure both doctors know about the other's findings and plans.
If you have a pre-existing eye condition, tell your obstetric team about it at your first prenatal visit. Share the name and contact information of your eye doctor so the two teams can communicate directly when needed.
Safe Eye Care During Pregnancy
If your contact lenses become uncomfortable during pregnancy, try switching to glasses until after delivery. If you prefer to keep wearing lenses, preservative-free rewetting drops can help. Your eye doctor may also suggest switching to daily disposable lenses, which tend to feel more comfortable because you start with a fresh pair each day.
Do not order a new contact lens prescription based on vision changes during pregnancy. Your refraction is likely to shift back after delivery, and you would need yet another update.
Not all eye drops are safe during pregnancy. Some glaucoma medications, for example, can affect the developing baby. Always tell your eye doctor that you are pregnant or breastfeeding before starting any new eye medication. Preservative-free artificial tears are generally considered safe throughout pregnancy.
If you need treatment for an eye condition during pregnancy, your eye doctor will choose medications with the best safety profile for pregnant women and use the lowest effective dose.
Eye doctors recommend postponing elective vision correction surgery, such as laser vision correction, until after pregnancy and breastfeeding. The hormonal changes that affect corneal shape and thickness during pregnancy can alter the measurements used to plan these procedures. Operating on a cornea that is still changing can lead to inaccurate results that need further correction later.
Most doctors suggest waiting at least three months after you stop breastfeeding and confirming that your prescription has stabilized before considering elective eye surgery.
Pregnancy-Related Eye Health Questions
Mild blurriness and dry eyes are common pregnancy symptoms caused by fluid retention and hormonal changes. They usually resolve within weeks after delivery. However, sudden or severe blurriness is not normal and should be evaluated right away, as it can be a sign of preeclampsia.
In most cases, yes. Hormonal and fluid changes reverse after delivery, and your cornea returns to its pre-pregnancy shape. Most eye doctors suggest waiting six to eight weeks postpartum before assessing whether a prescription change is truly needed.
Permanent vision loss from preeclampsia is rare but possible. Most vision changes, including serous retinal detachments, resolve after delivery and blood pressure stabilization. In severe cases, lasting damage to the retina or optic nerve can occur. Early detection and management of preeclampsia protect both your eyes and your overall health.
If you have pre-existing diabetes, the AAO recommends a dilated eye exam in the first trimester. If you do not have diabetes and are not experiencing eye symptoms, a routine dilated exam is not required solely because of pregnancy. Your doctor will advise based on your personal health history.
Preservative-free artificial tears are considered safe during pregnancy and breastfeeding. They provide relief from dryness and irritation without exposing you or your baby to medication. Avoid drops that contain vasoconstrictors (redness removers) unless your doctor approves them.
Previous eye surgery, including laser vision correction, does not pose a risk to your pregnancy. However, pregnancy-related changes in corneal shape may temporarily alter the results of your surgery. If you notice vision changes, let your eye doctor know. Your original results will likely return after delivery.
Protect Your Eyes and Your Baby
Pay attention to vision changes during pregnancy and report anything sudden or severe to your care team. If you have pre-existing diabetes, schedule a dilated eye exam in your first trimester. For all other expectant mothers, keep your eye doctor informed about your pregnancy, use preservative-free artificial tears for comfort, and do not hesitate to seek urgent care for symptoms like vision loss, flashing lights, or persistent spots.