Are you pregnant? Go to an ophthalmologist

We have already written about pregnancy in the context of a contraindication to laser correction. In this article, we would like to familiarise you with the topic of pregnancy and its termination in patients who have undergone ophthalmic surgery in the past or have problems related to the organ of vision. Every woman who finds out she is pregnant should think about visiting an ophthalmologist in addition to seeing her gynaecologist. Do you think this is an exaggeration? Nothing of the sort.

Of course, the need to visit an ophthalmologist is not for the sake of the foetus or to ensure the proper course of the pregnancy, but out of concern for the health of one's own eyes. Hormonal changes in the pregnant woman's body can affect the deterioration of visual acuity, but the greatest risk is pathological changes to the retina, whose condition should be verified by a funduscopic examination. There are also several indications for caesarean sections related to the organ of vision, which every woman in hope should be familiar with. During the nine months of pregnancy, every woman should have her eyes examined at least once by a specialist.

Which ladies in particular should get tested?

Above all, at the beginning of the pregnancy period, it is advisable* to direct your steps to an ophthalmologist for patients who:

- suffer from diabetic retinopathy
- have undergone retinal surgery or have degeneration of the retinal periphery
- have myopia degenerating
- have undergone laser vision correction
- chorują na jaskrę lub stożek rogówki.

Istnieją bowiem poważne ryzyka powikłań okulistycznych* w przypadku porodu drogami natury. Do wysokiego ryzyka należą m.in.: nawracające krwotoki do ciała szklistego, odwarstwienie siatkówki i zranienia oka operowanego w okresie do 1 miesiąca przed rozwiązaniem, niektóre stany pooperacyjne, zaawansowana jaskra ze zmianami w polu widzenia, a także diabetic retinopathy, która stanowi bardzo wyraźne wskazanie do wykonania cięcia cesarskiego. Zwykle pacjentki o tak poważnych schorzeniach oczu są świadome ciągłej kontroli okulistycznej, ale na wszelki wypadek wolimy przypomnieć, że okres ciążowy może dodatkowo zagrażać ich oczom. Niezadbanie o swoje oczy w czasie ciąży może powodować znaczne pogorszenie wzroku, które może wykraczać również poza okres ciąży. Eye examination is very important both when planning a natural birth and by caesarean section.¹

Eye examination during pregnancy

Also pregnant women, in the second and third trimester of pregnancy, following eye surgery should not delay visiting an eye specialist. It is particularly important to check the eyes after vitrectomy, but also after laser correction. If the thickness of the cornea after surgery is less than 350 micrometres - this is a serious indication for a caesarean section. It happens that women's eyesight deteriorates with natural childbirth, so it is very important to contact your ophthalmologist for a consultation about having a caesarean section. This can inhibit adverse changes to the eyeball, which can result in significant deterioration of vision. It has been recognised that there are no contraindications to natural childbirth for conditions such as:

• Glaucoma without visual field changes,
• Retinal detachment operated on more than 1 year before resolution with total retinal detachment.

However, in order to be sure that our eyes are in no danger and that an eye defect will not force us to have a caesarean section, it is essential to make a follow-up appointment with your ophthalmologist. Don't let your eyesight deteriorate in childbirth and take care of the health of your eyes.²

Visit to an ophthalmologist during pregnancy

Zmiany, które charakteryzują się niskim ryzykiem powikłań okulistycznych po naturalnym porodzie, to chociażby: krótkowzroczność bez zmian w plamce, jaskra bez zmian w polu widoczności, odwarstwienie siatkówki operowane w okresie więcej niż pełnego roku przed rozwiązaniem z całkowitym przyłożeniem siatkówki. Także średnio i bardzo zaawansowany stożek rogówki po zabiegu cross-linking wymaga sprawdzenia, czy choroba nie postępuje i jaka jest obecna grubość rogówki. Natomiast zmiany degeneracyjne obwodu oka oraz zwyrodnienia, które mogą predysponować do retinal detachments, powinny być zabezpieczone przy pomocy fotokoagulacji laserowej w okresie 1 miesiąca przed rozwiązaniem.

An ophthalmologist in pregnancy is therefore a necessity.

A lot of pregnant women do not realise the consequences of not having their eyes examined before giving birth. The changes that take place in a pregnant woman's body are very great, and it is therefore recommended that every pregnant woman, especially those affected by a visual defect, visit an ophthalmologist. The deterioration of vision can have long-term effects and last not only during pregnancy. The visual system of pregnant women should be thoroughly examined long before the planned birth. So take care of the condition of your eyes whether you will be using natural childbirth, which significantly increases venous pressure in the upper part of the body, or a caesarean section, which may be necessary in some cases of having a visual defect. Pregnant women should pay special attention not only to the health of their little one, but also to their own health. Don't let your eyesight deteriorate after childbirth, and be sure to make an appointment with a trusted specialist who knows his or her trade and will provide you with the right advice on your eyesight during pregnancy.

So while taking care of the little one you want, don't forget to take care of your own health!

*) According to the guidelines of the Polish Ophthalmological Society