Vision changes during pregnancy

Are your eyes deceiving you? Probably not: Vision changes during pregnancy are common. An estimated 14 percent of all women, in fact, report becoming more nearsighted or having blurry vision during pregnancy. Here's why – and what to do about it.

Why do I experience vision changes during pregnancy?

During pregnancy, changes in hormones, metabolism, fluid retention, and blood circulation can all affect your eyes and your eyesight.

Water retention, in particular, may slightly increase the thickness and curvature of your cornea. It's a small change, but it could affect whether your glasses or contacts still correct your vision perfectly – or cause your vision to look blurry even if you didn't need glasses before pregnancy. It's also the reason laser eye surgery isn't recommended during pregnancy, and why it's not a good time to be fitted for new contact lenses or invest in a new pair of glasses.

Hormonal changes can also make your eyes drier and more irritated during pregnancy (and for as long as you're breastfeeding), which can contribute to inaccurate vision. Combined with subtle changes in the shape and thickness of the cornea, you may find it's uncomfortable to wear contact lenses, especially hard lenses.

When does blurry vision in pregnancy begin?

The most common vision change during pregnancy – blurry vision – is usually linked to changes in the cornea and occurs mainly in the second and third trimesters.

If you do experience any vision changes during pregnancy, they will almost always be minor and temporary. Expect symptoms to reverse themselves within several months of delivery or after you finish breastfeeding.

Will I experience any other vision changes during pregnancy?

You may experience other vision changes during pregnancy, including:

• Visual disturbances from migraines. You may see flashing lights, zigzag lines, or blind spots caused by migraine headache with aura for the first time during pregnancy. A painful headache is preceded by an aura, although it's common to have visual symptoms without the headache. While very unpleasant, migrainesOpens a new window are rarely cause for concern. They're especially common in the first and early second trimester and tend to improve – even for women who've experienced them in the past – in the late second and third trimesters, due to higher estrogen levels. Please call your obstetrician if you start to experience these symptoms and they will need to rule out other more concerning causes of blurry vision. Your doctor can give you medication to help with these migraines as needed, and even suggest some medications or supplements to prevent them. Be sure to tell all of your medical providers about your migraines with auras as they may affect the type of contraception you are able to take in the future.
• Central serous chorioretinopathy. Some women with an otherwise healthy pregnancy develop a rare eye disease called central serous chorioretinopathy, where fluid builds up under the retina. This is uncommon, seen in just 4 in every 17,000 pregnant women. Layers of the retina then detach and distort vision, creating blind spots. It's cause is unknown but multiple factors during pregnancy can contribute, and most often develops in late pregnancy. Vision usually returns to normal toward the end of your pregnancy or within a few months after delivery.
• Diabetic eye disease. Pregnancy can trigger or worsen preexisting diabetic eye disease. If you were diagnosed with diabetes before getting pregnant, make sure to work on optimizing your blood sugar control prior to conceiving. In addition to seeing your endocrinologist prior to pregnancy, you should see your eye doctor before you get pregnant and again in early pregnancy to get screened for damage to the blood vessels in your retina (diabetic retinopathy). You'll also need to have more frequent eye exams while you're pregnant and in the postpartum period.

Preexisting glaucoma, on the other hand, sometimes improves during pregnancy. That means your eye doctor may be able to lower the dose of your medication – and reduce your baby's exposure to it.

Is there anything I can do to prevent blurry vision in pregnancy?

The good and bad news is that while there's not much you can do to prevent or treat blurry vision during pregnancy, your vision should return to normal after delivery.

If blurry vision during pregnancy is linked to dry eyes, try these tips:

• Use pregnancy-safe drops. Ask your ophthalmologist about using a pregnancy-safe over-the-counter or prescription eye lubricants. You may want to use them before bed, as they can sometimes actually contribute to blurry vision.
• Beware of eyewear. If you have contacts, try wearing them for shorter stretches of time. If that doesn't help, switch to glasses until you have your baby.
• Take regular breaks from screens. Staring at the TV, computer, or smartphone for long periods of time and not blinking as frequently as usual can make dryness and irritation worse.
• Put your screen below your eye level. If you're looking down, your eyes won't be as wide open – which may help conserve tears between blinks.

Are vision changes during pregnancy ever cause for concern?

If you think your vision has changed significantly, see an eye doctor (ophthalmologist) for an exam. If you wear glasses, it's unlikely that you'll need to change your prescription, but it is possible.

Sometimes, blurry vision in pregnancy can be a sign of a more serious condition, including preeclampsia or hyperthyroidism.

Preeclampsia or eclampsia

Some vision changes during pregnancy, including blurry vision, double vision, and temporary loss of vision, can be symptoms of preeclampsia or eclampsia. Preeclampsia is a potentially dangerous pregnancy complication that involves high blood pressure and develops in the last 20 weeks of pregnancy. Eclampsia is a complication of preeclampsia.

Changes in vision during pregnancy are one of the most serious signs of preeclampsia. About 25 percent of women with severe preeclampsia and 50 percent of women with eclampsia experience visual symptoms, which tend to worsen as the conditions become more severe.

Additional signs or symptoms of preeclampsia include headaches, new swelling of your legs, hands, and/ or face, new nausea or vomiting, pain in your right upper abdomen. If you think you might have preeclampsia, call your doctor or head to the hospital right away, as it requires prompt treatment.

Graves' eye disease and hyperthyroidism

Sometimes, a feeling of grittiness in the eyes, dry eye, and redeye can be symptoms of Graves' eye disease. This condition often develops in people with Graves' disease, the most common cause of an overactive thyroid (hyperthyroidism). However, not all people with eye symptoms develop hyperthyroidism.

You might be diagnosed with hyperthyroidism for the first time during pregnancy due to hormonal changes. It tends to get worse in the first trimester and improve later in pregnancy. If symptoms become severe, your doctor may put you on anti-thyroid medication.

When should I call my doctor about my blurry vision during pregnancy?

Be sure to call your doctor or midwife immediately if you experience severe blurry vision during pregnancy, especially if it's accompanied by any of these other visual symptoms:

• Eye floaters and/or flashes of light
• Blind spots
• Decreased vision
• Temporary loss of vision
• Double vision
• Irritation or grittiness in the eyes
• Redness or inflammation of the white part of the eyes
• Very watery or dry eyes
• Swollen eyelids
• Bulging eyes

It's also important to be aware of the signs of preeclampsia, which almost always appear during the second half of pregnancy; if you experience any, let your doctor know right away:

• Sudden and severe swelling in the face and hands
• Sudden weight gain
• Severe headaches
• Nausea or vomiting
• Decreased urine output
• Pain under your ribs on the right side

Learn more:

• Headaches during pregnancy
• Pregnancy symptoms you should never ignore
• How to handle pregnancy aches and pains