Vision Information for Mommies and Babies

50% of women who are pregnant or post partum will have noticeable vision changes. Very few of these changes are evident in the first two trimesters, but blurry vision or intermittent visual disturbances may be noticed third trimester through 3 months post partum.  It is important to know that visual changes may not be related to the pregnancy as well – they may be related to some other health problem so always consult with your optometrist/ophthalmologist.  Have your physician monitor blood levels regulaly and notify them if there is a family history of diabetes or gestational diabetes.

Some medical problems that may cause vision change during pregnancy include:

Pregnancy induced hypertension (pih)

For PIH early treatment is vital to minimize pregnancy complications; can result in shifting vision or retinal problems.

Preeclampsia and eclampsia (elevated blood pressure – severe)

Same concerns as PIH exist

Pituitary adenoma – (hormone secreting tumor)

Extremely rare – may be cause of tunnel vision or narrowing of vision – probably have other systemic problems prior to vision change.

Vision related symptoms during pregnancy

1. Intermittent blur – comes and goes – may be noticed first as trouble seeing road signs at night
2. Headache – may or may not be due to vision change
3. Dizziness
4. Auras (jagged flashes of light or colored light – migraine related – may be secondary to hormonal induced migraine
5. Double vision
6. Glare at night time
7. Light sensitivity
8. Eye strain
9. Flashes and floaters which can lead to retinal detachment –result of pushing during labor or straining to get up– flashes appear as bright spots or streaks of light that you can’t look directly at; floaters look like small bugs in your vision or wavy lines that move around and a retinal detachment usually presents as flashes and/or floaters followed by dimming vision – tell your doctor immediately if you experience any of these symptoms due to labor.

Many changes in vision due to pregnancy reverse themselves; some nearsighted women will have improved or worsening prescriptions that may be permanently retained

Contact lens related problems
1. Reduced tolerance to contact lenses brought on by dry eye from hormonal changes
2. Corneal edema – fluid between layers of cornea – similar to edema anywhere else in your body; ankles, bloating; secondary to irritation and hormonal changes – fluid in the clear cornea makes vision blurry – usually contact lens related only

It is a good idea to have updated prescription glasses when going into 2nd trimester – there may be times contact lenses become unsafe to wear or intolerable.

What should you do?

A. Remove contact lenses and check with optometrist
Find out if you can wear contact lenses in your hospital
– You may or may not be given the option to wear your contact lenses during delivery. It is advisable to not wear them, should an emergency procedure become necessary, there is not time to remove the lenses – be sure to have a pair of glasses available in your current prescription for your hospital stay. If you absolutely must wear them, ask you doctor to fit you in an extended wear contact lens that can stay in your eye for 1 or more weeks. There are risks for eye infections and inflammations if you do this, so be sure to discuss it with your optometrist and your obstetrician.

Should i have my prescription changed during pregnancy or immediately post partum?

This is up to you – the questions you want to ask yourself; do you feel you are seeing well enough to function? If so, may be better off holding off. Do you feel you are a hazard on the road? Common sense- -get a new prescription. You are usually better waiting until 3 months post partum to get a new eyeglass or contact lens prescription.

Eye drops – what is safe for pregnant women and what is not

Dilation during eye examination

While no studies to date have proven eye drops during eye exams harm the fetus, some of the drops used to dilate the eye have neurological effects and it is recommended that unless absolutely necessary, women not get dilated when attempting to conceive, during pregnancy or nursing
Over the counter eyedrops are harmless, but some contain chemicals that may cause an allergic reaction – consult your optometrist prior to using any over-the-counter eyedrops

I’m thinking about getting pregnant – can I still have LASIK laser vision correction?

Laser vision correction or other surgical vision correction options
should not be performed during pregnancy or nursing – there are many changes in the eye that may cause benefits of surgery to be lost – enhancements may be needed and there are added risks when this happens.

Information  for feti and babies

Nutrition
1. Researchers suggest that oily fishes such as sardines and mackerel assist development of vision in utero – recommended one serving of fish at least every 2 weeks (stereoacuity at 3.5 years of age in children born full-term is associated with prenatal and postnatal dietary factors; c williams, ee birch, pm emmett, k northstone and the alspac study team. American Journal of Clinical Nutrition, 2001)

Why? Fish is the richest source of dha, a fatty acid important in neuronal membranes found in the brain – DHA also present in breast milk but not in formula – be careful and consult with a nutritionist or your ob – some fishes are not safe to eat during pregnancy due to higher mercury levels – also, do not take any supplements of fish oils, dha or anything else without consulting your doctor.

A Positive association has been shown for breast feeding and development of vision in utero; Depth perception gained sooner in children in both cases

My childs 1st eye examination
If a Family history of eye disease including lazy eye, eye turns and glaucoma exists have the childs vision checked at 2 years
Premature infants are evaluated immediately in hospital
Signs of problem including unequal eyes, eye turns, mucous in one eye, red eye lid (one only) or premature birth – have evaluation post-natally up to 6 months of age.  Clogged tear ducts are common – they usually fix themselves, but if actively clogged for more than 1 week, consult your obstetrician – may have you gently massage the skin over the tear duct and may.  Supplement with erythromycin ophthalmic ointment – consult with physician only before massaging or instilling anything into your childs eyes.

One pupil may be larger than the other – this is common, don’t panic. Make sure both pupils react to light and have a pediatric ophthalmologist evaluate any pupil differences – most likely ok but check anyway.
Remember, learning is 85% visual, so any problem with eye coordination or vision may lead to slower visual and learning development.  Many eye –vision related problems can be helped up to around age 7, so don’t delay having your child’s vision checked – many problems can be avoided.
Between 3rd and 4th grade, print in school gets noticeably smaller, and many advanced children read chapter books earlier, so a bright child who suddenly has problems in school may just be having trouble with smaller print or eyestrain. This is especially true if the Child passes the school screening – farsighted children will often go undetected, because they can over-focus through any test a School nurse can administer, but since they are farsighted, they see well far but are strained or blurry at near. Be sure an eye doctor screens for farsightedness – the pediatrician usually only screens for nearsightedness and other problems that are easily detected.

Toys and other objects to help with infant vision development
1. Black and white high contrast toys are excellent – help brain cortex to develop
2. Swinging toys help child to follow and cross midline – mobiles are great – even better when they are black, white and red
3. Fish tanks are excellent – multiple colors, shapes and moving objects help child to follow – not too small but not necessary to have over 45 gallon tank
4. Screen savers – different shapes like changing balls, tubes or varying objects are great to have your child watch – it will keep them entertained – have them sit on your lap and stimulate them while they follow the screen saver around
5. Potted trees – holding a baby infront of a tree and gently shaking it can keep them entertained for a long time! They will enjoy watching the movement and following it; you can supplement this activity by holding their hand towards a leaf – this helps with hand/eye coordination and development of the visual/spatial relationship as well as sense of touch. Don’t hold them too close as the leaf or a branch may scratch them.
6. Your child will enjoy looking at bright lights, fixtures and lamps. If the lamp is a hanging lamp and can be gently pushed so it sways ever so slightly, it will help the baby learn to follow and track objects – make sure the baby is far enough away from the fixture so the fixture can’t harm the baby should it fall. Always be careful and don’t sway the fixture too much. Make sure you are close by and observing while doing this exercise. – don’t leave a swinging fixture unattended with a baby near by.

Courtesy of the Doctors at Shady Grove Eye and Vision Care; Optometrists, Ophthalmologists and Opticians working together to help you see better.  Serving the Rockville, Potomac and Gaithersburg Maryland suburbs of Washington, DC for over 40 years. For more information visit youreyesite.com or call (301) 670-1212

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5 Responses

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  4. Eye Floaters are bothersome. I am glad to acknowledge that other persons have the same annoyance as I do. I will keep coming back for updates.

  5. […] research reveals that kids under the age of 12 perceive visual information differently than adults do. While adults process different visual cues into one unified chunk of […]

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