Pregnancy is a time of exceptional care for health – both of the developing child and the future mother herself. Although most attention is focused on visits to the gynecologist and prenatal tests, we often forget about another, extremely important aspect: eye health. As emphasized by Prof. Agnieszka Kamińska, an experienced ophthalmologist specializing in the treatment of eye diseases in children, eye check-ups during pregnancy are not a whim, but a necessity that can be crucial for the mother's health and the course of labor.

When to see an ophthalmologist? The sooner the better!

The basic question is: should a pregnant woman visit an ophthalmologist and when? Prof. Kamińska's answer is clear: yes, and as soon as possible after pregnancy is confirmed.

"Fortunately, gynecologists refer to an ophthalmologist, but unfortunately too late," notes prof. hab. n. med. Agnieszka Kamińska. "They send mothers to an ophthalmologist when they are a month away from giving birth. And we have a problem."

Why is an early visit so important?

• Detection of degenerative changes: Many young women, especially those with myopia (which is becoming increasingly common, among others, due to excessive use of digital devices), may experience degenerative changes on the retina, or even tears. Such conditions often require laser protection.
• Time to act: Retinal laser therapy needs time to be effective. "For the laser to be effective and efficient, i.e. to protect these degenerative changes, a minimum of four weeks, and preferably six, must pass between the time of laser treatment and the time of delivery," explains Prof. Kamińska. An examination shortly before delivery prevents effective intervention.
• Assessment of general health: The fundus of the eye is a place where symptoms of systemic diseases, such as hypertension or diabetes (including gestational diabetes), can be observed. An ophthalmologist can detect subtle vascular changes that may indicate these conditions.
• Eligibility for delivery: The condition of the retina, especially with high myopia or existing changes, affects the qualification for the type of delivery. Although visual impairment itself is not an automatic indication for a cesarean section, advanced degenerative changes or the risk of retinal detachment during labor may prompt doctors to recommend a cesarean section. Early diagnosis allows for an informed decision.

How does pregnancy affect the eyes?

The hormonal storm that accompanies pregnancy does not remain without its impact on the organ of vision:

• Changes in corneal hydration: Hormones can cause the body to retain more water, which also applies to the cornea. It becomes slightly thicker, "swollen".
• Temporary deterioration of vision: The effect of changes in the cornea may be a temporary deterioration in visual acuity or seeing "as if through a fog".
• Variations of the visual defect: The existing visual defect may change temporarily. Therefore, it is not recommended to change glasses during pregnancy or while breastfeeding. "After giving birth, and especially after breastfeeding, this visual defect may change by even one or two diopters" - says Prof. Kamińska. It is best to choose a new correction only after the breastfeeding period is over.
• Potential worsening of myopia: Although the mechanism is not fully understood, it has been observed that pregnancy can sometimes contribute to the progression of myopia.
  

Not only for mothers with visual defects!

Prof. Kamińska emphasizes that a visit to an ophthalmologist at the beginning of pregnancy is recommended for all women, not only those who wear glasses or contact lenses. A routine examination of the fundus of the eye allows to exclude hidden problems and provides certainty that the organ of vision is prepared for the changes and effort associated with pregnancy and childbirth.

Ophthalmologist – a primary care physician?

Unfortunately, an ophthalmologist is often not perceived as a doctor we go to for preventive purposes. We usually go to them when "something happens" – when our vision deteriorates or other ailments appear. Pregnancy is the perfect time to change this approach.

"We get used to good things very quickly. For us, it is something completely natural that we can see," notes Prof. Kamińska, comparing it to appreciating the efficiency of our legs only after they have been sprained. Awareness of how valuable our eyesight is and how many factors can affect it should encourage regular check-ups.

An appeal to future parents

The message is simple: if you are expecting a child, make an appointment with an ophthalmologist immediately after your visit to the gynecologist to confirm your pregnancy. This is an investment in your health, safety of delivery and comfort in your new role. Let's also remember that taking care of your eyesight concerns everyone - including future fathers, who need to be fully strong to support their partners and raise their little ones together.

The article is based on a conversation with prof. dr hab. n. med. Agnieszka Kamińska, a specialist in eye diseases, who runs, among others, the Szwedzka Clinic.