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If you are considering becoming pregnant, but have concerns because of your glaucoma, take heart. You are not alone. Many women with glaucoma have asked us about how glaucoma affects a pregnancy and if glaucoma medications can have harmful effects on the baby.
The following article strives to address some of these important issues. Be sure to discuss your plans and concerns with your health care team.
It is important to be aware of the changes that are going on in your body during pregnancy and how they could affect your eyesight. In general, eye pressure actually tends to decrease in pregnant women, possibly due to the body’s hormonal changes. This may be beneficial to some women with glaucoma.
If you have glaucoma and are also diabetic, be aware that women with diabetes need extra prenatal planning and careful diabetes management to ensure a healthy pregnancy. Diabetic retinopathy, an eye disease that is a common complication of diabetes, often progresses much more quickly during pregnancy. For more information on diabetes and pregnancy, you can contact the American Diabetes Association at 1-800-DIABETES or visit their website, www.diabetes.org.
It is important to realize that any glaucoma medication may affect the fetus. Unfortunately, there is very little human data on the use of glaucoma eyedrop medications during pregnancy. For most of these medications, risk cannot be ruled out. Again, it is important to discuss your glaucoma treatments with your health care team. Demecarium bromide (Humorsol) is one eyedrop medication that is not recommended during pregnancy. Oral (taken in a tablet or pill) carbonic anhydrase inhibitors should be used with caution in the first trimester because of reports of teratogenicity (deformity of the embryo) in laboratory animals.
Concerns about glaucoma medications should not end with delivery of the baby. If you want to nurse your baby, consider that glaucoma medications, like other medications, can be passed on through breast milk. For example, beta blocker medications actually concentrate in breast milk, and should be avoided if possible by nursing mothers.
Work with your eye doctor. The first three months of pregnancy, when most of the infant’s organs initially form, are especially critical. It is important to get your eye doctor involved as early as possible in order to plan the best treatment regimen for your pregnancy. It is even better if you can let your eye doctor know if you are planning to conceive. That way, a medication regimen can be planned or adjusted even before the baby is conceived.
When using eye drops, you can minimize the absorption of the medication into your bloodstream by gently pressing on the inside corner of the eye. Glaucoma medications, like many medications, are systemic, which means that they not only affect your eyes, but can travel through the rest of your body as well. By practicing this technique, you minimize the amount of medication that could cross the placenta or get into your breast milk. Be sure to demonstrate this technique, called nasolacrimal occlusion, to your eye doctor.
Article by Anne L. Coleman, MD, PhD, Associate Professor of Ophthalmology at the Jules Stein Eye Institute, University of California in Los Angeles.
Last reviewed on October 29, 2017