More women are becoming pregnant later in life. With age comes the greater chance of health issues, including eye diseases. Today, ophthalmologists are treating a large number of women who have glaucoma while pregnant. Many patients with congenital, pediatric or juvenile-onset glaucoma become adults wishing to start a family. The challenge in treating this group is balancing the risk to the mother’s vision against the potential for harm to the fetus. It is very important for ophthalmologists to manage these risks and to understand the needs of these patients.
Dr. Jay Katz, director of the glaucoma service at Wills Eye Institute noted that intraocular pressure often decreases during pregnancy, probably due to shifts in hormone levels, particularly estrogen. However, in some patients IOP will increase, he said. Clinicians should approach treatment case by case. It the disease is mils and early in its course, the eye doctor may feel more comfortable taking the patient off the medication and simply monitoring their eye pressures and visual field. Doctors may be reluctant to stop medications in a patient with more advanced glaucoma. Based on the level of the disease, ophthalmologists should identify appropriate medications and treatment to minimize the risk to the fetus.