Ocular changes during pregnancy

Pregnancy is often associated with ocular changes which are mostly transient but in some cases permanent. The ocular changes in pregnancy are either physiological or pathological. Pregnancy can improve or exacerbate the pre-existing ocular conditions. Pregnancy per se is associated with a hypercoagulable state and this may lead to occlusive vascular diseases of the choroid and retina. Diabetic retinopathy may result in worsening of the disease during pregnancy. On the other hand, there can be improvement of optic neuritis, uveitis, glaucoma or thyroid orbitopathy. Physiological changes include periocular skin, corneal and lens changes or changes in the intraocular pressure and visual field. Pathological changes include central serous retinopathy. Preeclampsia, eclampsia and HELLP syndrome are gestational diseases, which can also manifest themselves with ocular symptoms. Spontaneous vaginal delivery is not contraindicated in pregnant women with risk factors for retinal detachment if appropriate care is given before delivery, as necessary.