Luke K Hopstad OD

Eye diagnosis during pregnancy
Examination of the visual apparatus is carried out for all pregnant women, regardless of whether there is a history of eye diseases or the woman is healthy.

The need for diagnosis is associated with sudden changes in the hormonal background, which can negatively affect the function of vision. The eyes during pregnancy undergo structural changes in the area of the retina, creating a risk of complications.

Examination of the visual organs is carried out for the following purposes:

prevention of pathologies of the retina;
timely detection of diseases in the early stages of development;
prevention of complications from the visual organs in the postpartum period;
preparation and permission of the gynecologist for independent childbirth.

With normal vision, a woman is prescribed a diagnosis of the visual apparatus twice: in the first trimester (10-14 weeks), in the third trimester (34-36 weeks).

Pregnancy and vision are closely related, the choice of the method of delivery depends on the condition of the eyes. Natural childbirth is dangerous for women with such eye diseases as progressive myopia of one or both eyes, severe glaucoma, a combination of myopia with chronic diseases of the internal organs (diabetes mellitus, goiter, pyelonephritis, anemia, benign neoplasms, COPD).
Safe methods for diagnosing vision in pregnant women

Examination of the visual organs in medical and diagnostic centers equipped with innovative equipment is safe for both women and the fetus. During the initial visit, the ophthalmologist conducts an examination and assesses the quality and acuity of vision, the condition of the fundus, the anterior chamber, checks the field of vision, and, if necessary, measures intraocular pressure.

Complex of instrumental methods of eye examination in pregnant women:

ophthalmoscopy – the study of the fundus using a fundus lens or ophthalmoscope, reveals thinned areas of the retina, places of rupture, the state of the optic nerve;
refractometry-the study of refraction (changing the direction of the beam) using a refractometer, the method determines how correctly the optical system of the eye is able to distinguish distant objects (detect myopia, farsightedness, astigmatism);
visiometry-determination of visual acuity using special tables;
ocular tonometry-measurement of pressure in the eye (increased pressure is the main sign of glaucoma).

Methods of research on ophthalmic equipment are carried out with an enlarged pupil. To do this, 1-2 drops of a special drug (mydriatic) are instilled into the conjunctival sac. This procedure is painless, does not cause discomfort. Eye drops do not penetrate the systemic circulation and do not have a toxic effect on the fetus.

If the eyes hurt during pregnancy, the quality of vision noticeably worsens, examinations at the ophthalmologist are carried out more often. This is necessary to detect the causes-changes or anomalies of refraction, dystrophy of the structures of the visual apparatus, infectious and inflammatory processes.

There are no contraindications to eye examination. If a woman has signs of acute inflammation – redness, swelling, purulent-serous mucosal discharge, instrumental diagnosis is postponed until the elimination of clinical symptoms.

Useful information For the middle of 2020, in the eye microsurgery clinic “Oculus”, eye diagnostics during pregnancy – 1200 rubles.
Recommendations of an optometrist for a pregnant woman

Eye diagnosis in pregnancy Vision during pregnancy may worsen gradually. Women often do not attach importance to this, writing off this condition as fatigue. If there are pathological changes in the retina – dystrophy, degeneration, thinning, tears, angiopathy (blood vessel damage), it is recommended to perform laser retinal coagulation (PPLC). If not treated, such processes will lead to retinal detachment and irreversible vision loss.

Peripheral dystrophy is the main reason for the refusal of pregnant women in natural childbirth. I plan a caesarean section for such women. Laser coagulation solves this problem. The technique is absolutely safe, has no serious contraindications. The intervention is performed under local anesthesia, non-contact and bloodless, which makes infection impossible.

The operation is recommended to be performed before the 35th week of pregnancy. The manipulation takes place on an outpatient basis, after which the woman goes home. There is no recovery period, there is no need to change the usual way of life.
Independent birth and vision

Since the retina of the eye is vulnerable during pregnancy and its condition is affected by such factors as hormonal changes, toxicosis, the decision to give birth independently is made only by a doctor (obstetrician-gynecologist, ophthalmologist).

The main criterion for admission to natural childbirth is the normal state of the fundus. Independent childbirth is contraindicated in cases of moderate to high myopia (myopia of 6 diopters or more), hypermetropia (hyperopia with pronounced strabismus).

In such conditions, there is a high probability of developing complications and the appearance of symptoms such as a veil in front of the eyes, distortion of visible objects, loss of individual areas from the field of view, violation of central vision, photopsias (lightning flashes in the eye). This indicates retinal detachment and requires urgent surgical treatment. Drug therapy is not effective.
Prevention of complications after childbirth

Early prevention of vision loss after childbirth consists in regular visits to an ophthalmologist and monitoring of progressive pathology. As changes occur, the doctor will prescribe medication or wear corrective devices (glasses, lenses).

To avoid complications in the postpartum period, you need to prepare for the birth itself. Learn proper breathing, how to behave when trying. The degree of risk of postpartum negative consequences for the eyes – hemorrhages, damage to the retina-depends on the control of behavior, psychoemotional mood.

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