Skip to main content
SpringerLink
Log in

Ocular Manifestations of Pregnancy

  • Chapter
  • First Online:
Retinal and Choroidal Manifestations of Selected Systemic Diseases

Abstract

Pregnancy may be associated with ocular changes, which most often are transient in nature. It can exacerbate preexisting conditions or be associated with development of new conditions. The ocular effects of pregnancy may be divided into physiologic changes, pathologic conditions, or modifications of preexisting conditions. Pathologic conditions include entities such as preeclampsia and eclampsia, along with conditions that are seen with increased frequency during pregnancy such as central serous chorioretinopathy. The most significant modified preexisting condition is diabetes mellitus. The various effects of pregnancy on the eye will be reviewed throughout this chapter.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 84.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 159.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 109.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Sunness JS. The pregnant woman’s eye. Surv Ophthalmol. 1988;32:219–38.

    Article  PubMed  CAS  Google Scholar 

  2. Philips CI, Gore SM. Ocular hypotensive effect of late pregnancy with and without high blood pressure. Br J Ophthalmol. 1985;69:117–9.

    Article  Google Scholar 

  3. Paterson GL, Miller SJH. Hormonal influences in simple glaucoma. Br J Ophthalmol. 1963;47:129–37.

    Article  PubMed  CAS  Google Scholar 

  4. Wilke L. Episcleral venous pressure and pregnancy. Acta Ophthalmol (Copen). 1975;125(Suppl):40–41.

    Google Scholar 

  5. Horven I, Gjonnaess H, Kroese A. Corneal indentation pulse and intraocular pressure in pregnancy. Arch Ophthalmol. 1974;91:92–8.

    Article  PubMed  CAS  Google Scholar 

  6. Riss B, Riss P. Corneal sensitivity in pregnancy. Ophthalmologica. 1981;183:57–62.

    Article  PubMed  CAS  Google Scholar 

  7. Weinreb RN, Lu A, Beeson C. Maternal corneal thickness during pregnancy. Am J Ophthalmol. 1988;105: 258–60.

    PubMed  CAS  Google Scholar 

  8. Park SB, Lindahl KJ, Temnycky GO, Aquavella JV. The effect of pregnancy on the corneal curvature. CLAO J. 1992;18:256–9.

    PubMed  CAS  Google Scholar 

  9. Millodot M. The influence of pregnancy on the sensitivity of the cornea. Br J Ophthalmol. 1977;61: 646–9.

    Article  PubMed  CAS  Google Scholar 

  10. Fatt I, Harris MG. Refractive index of the cornea as a function of its thickness. Am J Optom Physiol Opt. 1973;50:383–6.

    Article  CAS  Google Scholar 

  11. Schreyer P, Tzadok J, Sherman DJ, et al. Fluorescein angiography in hypertensive pregnancies. Int J Gynecol Obstet. 1990;34:127–32.

    Article  Google Scholar 

  12. Jaffe G, Schatz H. Ocular manifestations of preeclampsia. Am J Ophthalmol. 1987;103:309–15.

    PubMed  CAS  Google Scholar 

  13. Fry WE. Extensive bilateral retinal detachment in eclampsia with complete reattachment. Arch Ophthalmol. 1929;1:609–14.

    Article  Google Scholar 

  14. Hallum AV. Eye changes in hypertensive toxemia of pregnancy. JAMA. 1936;106:1649–51.

    Article  Google Scholar 

  15. Valluri S, Adelberg D, Curtis R, et al. Diagnostic indocyanine green angiography in preeclampsia. Am J Ophthalmol. 1996;122:672–7.

    PubMed  CAS  Google Scholar 

  16. Saito Y, Tano Y. Retinal pigment epithelial lesions associated with choroidal ischemia in preeclampsia. Retina. 1998;18:103–8.

    Article  PubMed  CAS  Google Scholar 

  17. Fry WE. Extensive bilateral retinal detachment in eclapmsia with complete retinal detachment. Arch Ophthalmol. 1929;1:609–614.

    Article  Google Scholar 

  18. Beck RW, Gamel JW, Willcourt RJ, Berman G. Acute ischemic optic neuropathy in severe preeclampsia. Am J Ophthalmol. 1980;90:342–6.

    PubMed  CAS  Google Scholar 

  19. Grimes DA, Ekbladh LE, McCartney WH. Cortical blindness in preeclampsia. Int J Gynaecol Obstet. 1980;17:601–3.

    PubMed  CAS  Google Scholar 

  20. Beeson JH, Duda EE. Computed axial tomography scan demonstration of cerebral edema in eclampsia preceded by blindness. Obstet Gynecol. 1982;60:529–32.

    PubMed  CAS  Google Scholar 

  21. Gupta LY, Mansour SE. Bilateral bullous retinal detachment as a complication of the HELLP syndrome. Can J Ophthalmol. 1994;29:242–5.

    PubMed  CAS  Google Scholar 

  22. Leff SR, Yarian DL, Masciulli L, et al. Vitreous haemorrhage as a complication of HELLP syndrome. Br J Ophthalmol. 1990;74:498–9.

    Article  PubMed  CAS  Google Scholar 

  23. Cunningham FG, MacDonald PC, Gant NF, et al. Hypertensive disorders in pregnancy. In: Williams obstetrics. 19th ed. Norwalk: Appleton & Lange; 1993. p. 764–5.

    Google Scholar 

  24. Sunness JS, Haller JA, Fine SL. Central serous retinopathy and pregnancy. Arch Ophthalmol. 1993;111:360–4.

    Article  PubMed  CAS  Google Scholar 

  25. Chumbley LC, Frank RN. Central serous retinopathy and pregnancy. Am J Ophthalmol. 1974;77:158–60.

    PubMed  CAS  Google Scholar 

  26. Fastenberg DM, Ober RR. Central serous choroidopathy in pregnancy. Arch Ophthalmol. 1983;101:1055–8.

    Article  PubMed  CAS  Google Scholar 

  27. Gass JDM. Central serous chorioretinopathy and white subretinal exudation during pregnancy. Arch Ophthalmol. 1991;109:677–81.

    Article  PubMed  CAS  Google Scholar 

  28. Blodi BA, Johnson MW, Gass JDM, et al. Purtscher’s-like retinopathy after childbirth. Ophthalmology. 1990;97:1654–959.

    PubMed  CAS  Google Scholar 

  29. Cogan D. Ocular involvement in disseminated intravascular coagulopathy. Arch Ophthalmol. 1975;93:1–8.

    Article  PubMed  CAS  Google Scholar 

  30. Hoines J, Buettner H. Ocular complications of disseminated intravascular coagulation (DIC) in abruptio placenta. Retina. 1989;9:105–9.

    Article  PubMed  CAS  Google Scholar 

  31. Amarosi EL, Ultmann JE. Thrombotic thrombocytopenic purpura: report of 16 cases and review of the literature. Medicine. 1962;45:139–59.

    Google Scholar 

  32. Percival SP. The eye and Moschcowitz’s disease (thrombotic thrombocytopenic purpura): a review of 182 cases. Trans Ophthalmol Soc UK. 1970;90:375–82.

    PubMed  CAS  Google Scholar 

  33. Lewellen DR, Singerman LJ. Thrombotic thrombocytopenic purpura with optic disk neovascularization, vitreous hemorrhage, retinal detachment, and optic atrophy. Am J Ophthalmol. 1980;89:840–4.

    PubMed  Google Scholar 

  34. Gum KB, Carter KD, Vine AK. Massive bilateral retinal vascular occlusion secondary to thrombocytopenic purpura. Retina. 1988;8:185–7.

    Article  PubMed  CAS  Google Scholar 

  35. Power MH, Regillo MC, Custis PH. Thrombotic thrombocytopenic purpura associated with purtscher retinopathy. Arch Ophthalmol. 1997;115:128–9.

    Article  PubMed  CAS  Google Scholar 

  36. Chang M, Herbert W. Retinal arteriolar occlusions following amniotic fluid embolism. Ophthalmology. 1984;91:1634–7.

    PubMed  CAS  Google Scholar 

  37. Klein BE, Moss SE, Klein R. Effect of pregnancy on progression of diabetic retinopathy. Diabetes Care. 1990;13:34–40.

    Article  PubMed  CAS  Google Scholar 

  38. Axer-Seigel R, Hod M, Fink-Cohen S, et al. Diabetic retinopathy during pregnancy. Ophthalmology. 1996;103:1815–9.

    Google Scholar 

  39. Phelps RL, Sakol P, Metzger BE, et al. Changes in diabetic retinopathy during pregnancy. Arch Ophthalmol. 1986;104:1806–10.

    Article  PubMed  CAS  Google Scholar 

  40. Moloney JB, Drury MI. The effect of pregnancy on the natural course of diabetic retinopathy. Am J Ophthalmol. 1982;93:745–56.

    PubMed  CAS  Google Scholar 

  41. Best RM, Chakravarthy U. Diabetic retinopathy in pregnancy. Br J Ophthalmol. 1997;81:249–51.

    Article  PubMed  CAS  Google Scholar 

  42. Sinclair SH, Nesler C, Foxman B, et al. Macular edema and pregnancy in insulin-dependent diabetes. Am J Ophthalmol. 1984;97:154–67.

    PubMed  CAS  Google Scholar 

  43. Chew EY, Mills JL, Metzger BE, et al. Metabolic control and progression of retinopathy. Diabetes Care. 1995;18:631–7.

    Article  PubMed  CAS  Google Scholar 

  44. Lauszus F, Klebe JG, Bek T. Diabetic retinopathy in pregnancy during tight metabolic control. Acta Obstet Gynecol Scand. 2000;79:367–70.

    Article  PubMed  CAS  Google Scholar 

  45. Sinclair SH, Nesler CL, Schwartz SS. Retinopathy in the pregnant diabetic. Clin Obstet Gynecol. 1985;28:536–52.

    Article  PubMed  CAS  Google Scholar 

  46. Kitzmiller JL, Main E, Ward B, et al. Insulin lispro and the development of proliferative diabetic retinopathy during pregnancy. Diabetes Care. 1999;22:874–6.

    Article  PubMed  CAS  Google Scholar 

  47. Chen HC, Newsom RS, Patel V, et al. Retinal blood flow changes during pregnancy in women with diabetes. Invest Ophthalmol Vis Sci. 1994;35:3199–208.

    PubMed  CAS  Google Scholar 

  48. Schocket LS, Grunwald JE, Tsang AF, et al. The effects of pregnancy on retinal hemodynamics in diabetic versus nondiabetic mothers. Am J Ophthalmol. 1999;128:477–84.

    Article  PubMed  CAS  Google Scholar 

  49. The Diabetic Retinopathy Study Research Group. Four risk factors for severe visual loss in diabetic retinopathy. Arch Ophthalmol. 1979;97:654–5.

    Article  Google Scholar 

  50. Stoessel KM, Liao PM, Thompson JT, Reece AE. Diabetic retinopathy and macular edema in pregnancy. Ophthalmology. 1991;98(suppl):146.

    Google Scholar 

  51. The American Academy of Ophthalmology. Diabetic retinopathy. Preferred practice patterns, vol. 13. San Francisco: The American Academy of Ophthalmology; 1998. p. 28.

    Google Scholar 

  52. Siegel R, Ainslie WH. Malignant ocular melanoma during pregnancy. JAMA. 1963;185:542–3.

    Article  PubMed  CAS  Google Scholar 

  53. Seddon JM, MacLaughlin DT, Albert DM, et al. Uveal melanomas presenting during pregnancy and the investigation of oestrogen receptors in melanomas. Br J Ophthalmol. 1982;66:695–704.

    Article  PubMed  CAS  Google Scholar 

  54. Shields C, Shields J, Eagle R, et al. Uveal melanoma and pregnancy. Ophthalmology. 1991;98:1667–73.

    PubMed  CAS  Google Scholar 

  55. McLeod BK. Choroidal osteoma presenting during pregnancy. Br J Ophthalmol. 1988;72:612–4.

    Article  PubMed  CAS  Google Scholar 

  56. Gass JDM. Stereoscopic atlas of macular diseases: a funduscopic and angiographic presentation. 4th ed. St. Louis: CV Mosby; 1997. p. 218–9.

    Google Scholar 

  57. Pitta C, Bergen R, Littwin S. Spontaneous regression of a choroidal hemangioma following pregnancy. Am J Ophthalmol. 1979;11:772–4.

    CAS  Google Scholar 

  58. Sunness JS. Pregnancy and the eye. Ophthalmol Clin North Am. 1992;5:623–40.

    Google Scholar 

  59. Samples JR, Meyer SM. Use of ophthalmic medications in pregnant and nursing women. Am J Ophthalmol. 1988;106:616–23.

    Article  PubMed  CAS  Google Scholar 

  60. Blaul G. Lokale betablocker wahrend der graviditat. Klin Monbl Augenheilkd. 1981;179:128–9.

    Article  PubMed  CAS  Google Scholar 

  61. Lustgarten JS, Podos SM. Topical timolol and the nursing mother. Arch Ophthalmol. 1983;101:1381.

    Article  PubMed  CAS  Google Scholar 

  62. Mattern J, Mayer PR. Excretion of fluorescein into breast milk. Am J Ophthalmol. 1990;109:598–9.

    PubMed  CAS  Google Scholar 

  63. McEnerney JK, Wong WP, Peyman GA. Evaluation of the teratogenicity of fluorescein sodium. Am J Ophthalmol. 1977;84:847–50.

    PubMed  CAS  Google Scholar 

  64. Salem H, Loux JJ, Smith S, Nichols CW. Evaluation of the toxicologic and teratogenic potentials of sodium fluorescein in the rat. Toxicology. 1979;12:143–50.

    Article  PubMed  CAS  Google Scholar 

  65. Halperin LS, Olk RJ, Soubrane G, Coscas G. Safety of fluorescein angiography during pregnancy. Am J Ophthalmol. 1990;109:563–6.

    PubMed  CAS  Google Scholar 

  66. Rudolf H, Goretzlehner G, Brugmann E, et al. Assessment of liver function using indocyanine green (Ujoviridin) during normal pregnancy, during labor and in puerperium (in German). Zentralbl Gynakol. 1977;99:1548–53.

    PubMed  CAS  Google Scholar 

  67. Fineman MS, Maguire JI, Fineman SW, Benson WE. Safety of indocyanine green angiography during pregnancy. Arch Ophthalmol. 2001;119:353–5.

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. The Retina Center, Bryan, TX, USA

    Derek Kuhl M.D.

  2. Department of Ophthalmology, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Naples, FL, USA

    Stephen G. Schwartz M.D., M.B.A.

  3. The Eye Institute, Medical College of Wisconsin, Milwaukee, WI, USA

    Bhavna P. Sheth M.D.

  4. Department of Ophthalmology and Visual Sciences, University of Illinois at Chicago, Chicago, IL, USA

    William F. Mieler M.D.

Authors
  1. Derek Kuhl M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Stephen G. Schwartz M.D., M.B.A.
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Bhavna P. Sheth M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. William F. Mieler M.D.
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to William F. Mieler M.D. .

Editor information

Editors and Affiliations

  1. Johns Hopkins University, School of Medicine, The Retina Division,Wilmer Eye Institute, Al-Oruba Street, PO Box 7191, Riyadh, 1010, Saudi Arabia

    J. Fernando Arévalo

Rights and permissions

Reprints and permissions

Copyright information

© 2013 Springer Science+Business Media New York

About this chapter

Cite this chapter

Kuhl, D., Schwartz, S.G., Sheth, B.P., Mieler, W.F. (2013). Ocular Manifestations of Pregnancy. In: Arévalo, J. (eds) Retinal and Choroidal Manifestations of Selected Systemic Diseases. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-3646-1_25

Download citation

  • DOI: https://doi.org/10.1007/978-1-4614-3646-1_25

  • Published:

  • Publisher Name: Springer, New York, NY

  • Print ISBN: 978-1-4614-3645-4

  • Online ISBN: 978-1-4614-3646-1

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation