Pregnancy and your eyes

Blurry vision is common in pregnancy, as the intense and rapid physical changes affect many bodily systems, including the eyes. As a result, pregnant women can experience blurry vision and other vision changes.

Although most pregnancy-related eye conditions are minor and temporary, some can indicate a more serious problem. Visual disturbances like double vision, flashing lights and vision loss require urgent medical attention.

Other common eye problems in pregnancy include eye twitching, dry eyes and eye floaters. Here, we explore some of the possible eye complaints that may present in pregnancy, their causes and what you should do if they occur.

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Blurred vision with pregnancy

Many pregnant women experience blurry vision, often due to harmless causes that resolve after pregnancy. In the later stages of pregnancy, changing hormones can cause a build-up of fluid in the eye, increasing the curvature and thickness of your cornea, causing blurred vision (Source: Healthline).

However, there are other, more serious causes of blurry vision in pregnancy, including diabetes, high blood pressure or pre-eclampsia, so you should always get checked out by your midwife or doctor.

Dizziness and blurred vision can go hand in hand during pregnancy due to multiple factors, including dehydration, heat, low blood pressure and reduced energy (Source: Very Well Family). Dizziness and blurry vision often coincide with morning sickness in the first trimester. Rest, drink plenty of fluids, avoid hot baths, eat little and often and avoid standing up too quickly to help prevent dizziness.

If you feel faint and have severe persistent dizziness, pain, bleeding, shortness of breath or blurred vision, see your GP urgently (Source: HSE).
Headaches during pregnancy can cause blurred vision in some cases. Women who usually suffer from headaches and migraine may discover that they become more frequent during pregnancy. Morning sickness and poor appetite can result in low blood sugar, which might also cause a headache.

Headaches and blurred vision can be related to high blood pressure (hypertension) in some cases, so always get checked out by a GP. A severe headache, with or without vision problems, can be a side effect of pre-eclampsia and requires urgent attention from your midwife or GP (Source: NHS).

What is pre-eclampsia during pregnancy?

Pre-eclampsia is a serious medical condition that causes high blood pressure, typically after 20 weeks of pregnancy.

Symptoms and signs include:

Seeing flashing lights
Visual disturbances
Headaches
Swelling of the hands, feet, ankles or face
Pain below the ribs
Sudden weight gain
Heartburn that doesn’t get better with antacids (Source: RCOG, Informed Health)

In severe cases, pre-eclampsia can be life-threatening for mother and baby and can even cause seizures, in a condition called eclampsia. Contact your doctor immediately if you have any of the listed symptoms.

Eye twitching during pregnancy

During pregnancy, eye twitching is usually caused by stress and tiredness. Eye twitching occurs due to a spasm of the upper or lower eyelid, and although it’s a nuisance, it’s generally harmless. A deficiency of some vitamins and minerals could lead to eye twitching. Eating a varied diet with plenty of fruit, leafy green vegetables, fish and grains can help you get enough of these essential nutrients.

Dry eyes in pregnancy

Hormonal changes can impact tear production, often leading to dry eyes in pregnancy (Source: RNIB). These changes are more significant in the third trimester, as pregnancy hormones alter the consistency and reduce the volume of your tears.

Some of the symptoms and signs of eye dryness in pregnancy include:

Light sensitivity
Itchy eyes
Red eyes
Difficulty wearing contact lenses
Dried mucus around the eyes

Although dry eyes in pregnancy can be uncomfortable, it generally resolves after your baby is born or when you stop breastfeeding.

Factors unrelated to pregnancy, such as allergies, medication and using computer screens without enough breaks, can also cause dry eyes.

Treatments for dry eyes depend on the cause but generally artificial tears to wet your eyes will help make them more comfortable. Your pharmacist or ophthalmology specialist can advise on the best course of treatment for your situation.

Eye floaters in pregnancy

Eye floaters are tiny spots or specks that often appear in your peripheral vision then drift about in your line of sight.

Eye floaters can be harmless in some cases, but it is always safest to get them checked out by your doctor or ophthalmologist as they could be a sign of pre-eclampsia.

The following visual disturbances also require medical attention:

Experiencing eye flashes during pregnancy can be a warning sign of dangerously high blood pressure, which can occur on its own or as a symptom of pre-eclampsia. This serious condition needs urgent medical attention and can be dangerous if left untreated. In some cases, eye flashes are due to migraine, but always get checked out by a medical professional to be sure.

Itchy eyes in pregnancy

Itchy eyes are a common early pregnancy symptom caused by hormones and water retention. Just as fluid retention makes your ankles or legs swell in pregnancy, your eyes can also experience swelling, leading to irritation and itching.

Hormones influence your body’s ability to produce tears (Source: NIH). Normal hormonal changes of pregnancy can result in moisture loss in the eyes, causing itching and other symptoms linked to dry eyes.

Frequently asked questions

It's safe to attend an eye exam when pregnant. However, you should inform your eye doctor of your pregnancy beforehand, as it may affect some of the examination techniques and medications they use. Many pregnancy eye problems resolve once your baby is born, but it’s always best to get them checked out by an optometrist or see your doctor for advice.

Although eye exams are safe, most doctors advise against invasive procedures, like laser eye surgery (LASIK) during pregnancy.
It is safer to avoid taking any medication unless necessary, so always consult your doctor, midwife or pharmacist before using eye drops in pregnancy.

Your doctor can discuss the benefits and risks with you and explore other treatments, like over-the-counter lubricating eye drops, known as artificial tears, that contain no active medication.
Diabetes is a risk factor for developing eye problems. High blood sugar levels from diabetes damage the tiny blood vessels in the retina, in a condition called diabetic retinopathy. Pregnancy can accelerate the progress of diabetic retinopathy, although in some cases, the changes resolve after your baby is born. It’s worth noting that gestational diabetes does not increase the risk of diabetic retinopathy (Source: NIH).

You should receive close monitoring and advice from your healthcare provider or ophthalmologist if you have diabetes and are pregnant.

Conclusion

Some vision problems and eye changes can be a normal part of pregnancy, but it’s important to be aware of eye symptoms that might indicate a dangerous underlying health condition.

Visual disturbances like eye floaters, spots in your vision, or flashing require urgent medical attention. Other, less serious eye complaints, including dry eyes, itching, and twitching eyes, can be due to hormonal changes, water retention and tiredness. If you're concerned about any changes in your eye health or eyesight, see your doctor or midwife for advice.

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Medically reviewed by: The Royal College of Ophthalmologists on 28/07/2022

Edited by: Nick Astbury FRCS FRCOphth FRCP
Clinical Associate Professor
LSHTM

The Royal College of Ophthalmologists champions excellence in the practice of ophthalmology and is the only professional membership body for medically qualified ophthalmologists. The RCOphth is unable to offer direct advice to patients. If you’re concerned about the health of your eyes, you should seek medical advice from your GP, optometrist or ophthalmologist.