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Glaucoma and Pregnancy

Traditionally, pregnancy has been relatively rare among glaucoma patients. But as more women start families later in life, it is now more common for female glaucoma patients to become pregnant.

In addition, due to advances in diagnostic tools and increasing clinical awareness, we are detecting glaucoma at earlier ages in our patients.

Studies of pregnant women with ocular hypertension (but not glaucoma) show that eye pressure decreases as pregnancy progresses. In the past, many believed that this natural reduction in eye pressure would stabilize glaucoma patients and reduce the need for treatment during pregnancy.

However, a recent study of pregnant women with glaucoma showed that up to 60% of women had worsening visual fields and/or eye pressure increase during pregnancy. We now know that the course of glaucoma among pregnant women is highly variable, so they must be monitored very closely.

Should You Be Concerned about Medications?

If you have glaucoma and are pregnant or planning for a pregnancy, you are probably concerned about taking medications that might be harmful to your baby. In general, medications should be avoided during pregnancy, but as each patient’s situation is unique, it is best to discuss your options with your eye doctor.

One option for women with more advanced glaucoma who plan to become pregnant is laser eye surgery. Selective laser trabeculoplasty (SLT) and argon laser trabeculoplasty (ALT) are safe, non-medical glaucoma treatments, with pressure-lowering benefits that may allow for discontinuation of glaucoma drops during pregnancy.

Whenever possible, it’s best to address treatment options before becoming pregnant. With proper planning, surgery such as trabeculoplasty can be performed in anticipation of stopping or slowing progression of glaucoma during pregnancy.

Remember: by planning ahead (when possible), and working with your eye doctor, you can minimize any potential risk to your baby while preserving your vision.

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Article by Terri Pickering, MD. Dr. Pickering is on clinical faculty at California Pacific Medical Center; she is a researcher with the Glaucoma Research and Education Group in San Francisco, and past Chair of the Saint Mary’s Hospital Department of Ophthalmology.

Last reviewed on October 29, 2017

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