Glaucoma and Pregnancy: What Expectant Mothers Should Know

Glaucoma is a group of eye conditions that damage the optic nerve. Glaucoma is often associated with abnormally high eye pressure but may also occur when eye pressure is within the average range.

Managing glaucoma during pregnancy presents unique challenges, as the condition can affect maternal health, and its treatment can impact fetal health.

Pregnancy induces various physiological changes such as:

Typically, eye pressure tends to decrease in pregnant women without glaucoma, likely due to hormonal shifts. However, in glaucoma patients who are pregnant, eye pressure may increase, decrease, or remain stable.

Monitoring of glaucoma throughout pregnancy is crucial. Pregnant women with glaucoma require individually tailored treatment plans to reduce potential risks to the developing fetus. Collaboration between ophthalmologists and obstetricians is essential to ensure the best outcomes for both mother and child.

Medication Adjustments

There is limited human data on the safety of using glaucoma medications during pregnancy. Therefore, potentially, any glaucoma medication can affect the fetus. It’s crucial to discuss your glaucoma treatments with your healthcare team.

Oral carbonic anhydrase inhibitors (taken as oral tablets or pills) should be used with caution during the first trimester due to reports of teratogenic effects (embryo deformities) in laboratory animals. In addition, medications such as alpha agonists and prostaglandin analogs might need to be adjusted or replaced.

Concerns about glaucoma medications continue even after delivery. If you plan to nurse your baby, be aware that glaucoma medications, like other medications, can be passed through breast milk. For instance, alpha agonist medications tend to concentrate in breast milk and are contraindicated in nursing mothers.

Regular Monitoring

To manage your glaucoma effectively, you must have regular eye check-ups. Your eye care specialist might recommend more frequent visits to adjust treatment as needed.

Glaucoma Medications

Some glaucoma medications may pose risks during and after pregnancy. Inform your treating ophthalmologist at once when your pregnancy is confirmed to discuss whether your treatment and/or monitoring schedule need to be adjusted. When possible, it is best to have this discussion even before pregnancy begins so that you and your doctor can have a management plan in place prior to the first trimester.

Surgical Interventions

In some cases, surgery might be necessary to control glaucoma. Laser treatments or surgical procedures can be considered, but you should discuss these thoroughly with your eye doctor.

Breastfeeding Considerations

If you plan to breastfeed, it is crucial to have a conversation with your doctor about the medications you are taking for glaucoma. This is important because certain drugs used to treat glaucoma can pass into breast milk. These medications can then affect your baby’s health. Your doctor can help you understand which medications are safe to use while breastfeeding and may adjust your treatment plan to ensure both your safety and the well-being of your baby.

Managing glaucoma during pregnancy requires careful planning and collaboration with healthcare providers. Expectant mothers can protect their vision and ensure a healthy pregnancy by understanding the potential impacts and making necessary adjustments. Always consult with your ophthalmologist and obstetrician to tailor a safe treatment plan for both you and your baby.

Article reviewed for medical accuracy by Terri-Diann Pickering, MD and Sunita Radhakrishnan, MD. Posted on August 9, 2024.