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Dry Eyes and Pregnancy: Why and How to Manage

Congratulations! It’s… Dry Eye? How Pregnancy Affects the Eyes

(I-MED Pharma)

Dry eye syndrome statistically affects women more than men. A theory for this is that hormones cause dry eyes, and these hormone changes throughout a woman’s life can fluctuate during menstruation, menopause, and even pregnancy. The reasons for dry eye during pregnancy are important to be understood and should be noted to establish preventative measures especially early on.


Can pregnancy cause dry eye? Early pregnancy to third trimester hormonal effectsCan pregnancy cause dry eye? Hormonal effects from early pregnancy to the third trimester

Hormone changes throughout pregnancy can trigger dry eye. In fact, a 2021 study titled, “Dry eye, its clinical subtypes and associated factors in healthy pregnancy: A cross-sectional study” concluded that pregnant women from the first to the third trimester showed a high frequency of dry eye and it is associated with increasing gestational age. [1] They noted that while most dry eye could not be classified, evaporative dry eye was more common compared to aqueous deficient dry eye. To confirm this point further, a 2022 study titled, “The effect of pregnancy on meibomian gland, tear film, cornea and anterior segment parameters” found that meibomian gland loss was high in pregnant individuals compared to non-pregnant individuals. [2] The same hormones that cause an increase in acne while pregnant can also cause the meibomian glands or lipid/oil glands to change during pregnancy. [3] The meibomian glands are integral to a healthy ocular surface, seeing as they coat the tears with an oily substance that helps lock in moisture and allows the eyes to stay moisturized. A problem with the meibomian glands could result in tears that evaporate too quickly, leading to dry eye. In general, dry eye syndrome related to pregnancy usually worsens at the end of the first trimester due to massive hormonal changes. [4] After pregnancy, symptoms may linger postpartum due to the rebalancing of hormones. Breastfeeding and dry eyes also have a relationship, as shown in a 2023 study titled, “The Breastfeeding Effect On The Tear Film Of Women: An Observational Study” that found that breastfeeding increased dry eye symptoms in women. [5] However, it is common for these symptoms to resolve itself after weaning.


How else does pregnancy affect the eyes?

Aside from dry eye, pregnancy can affect the eyes in various ways. Issues like blurred vision, vision loss, and other ocular surface diseases can occur. It should be noted that various ocular disorders are more likely to arise in combination with other pre-existing conditions, such as diabetes. Additionally, the skin around the eyes can change pigmentation and get darker. Darkening of the face during pregnancy is referred to as pregnancy mask, cloasma or melasma and develops through increased estrogen, progesterone and melanocyte-stimulating hormone. [6] There is also a possibility of dryness in the eyes occurring due to dehydration from bouts of nausea in instances of morning sickness. During pregnancy, the eye itself can also change. Towards the end of pregnancy, the cornea may decrease in sensitivity and changes in the thickness of the cornea can occur. [7] Due to these changes within the eye itself during pregnancy, it may make wearing contact lenses intolerable or increasingly uncomfortable.


How to manage dry eyes during pregnancy?

How to treat dry eyes during pregnancy

How to treat dry eyes during pregnancy will vary from person to person. An omega-3 supplement can help regulate inflammation levels in the body which can help support tear function and help relieve dry eye symptoms. Additionally, preservative free artificial tears can also be a way to help manage symptoms of dry eye. It is also important to implement an ocular hygiene routine, to keep the eyes hydrated and clean as much as possible during this time. Additionally, punctum plugs can be a safe way for pregnant individuals to help relieve chronic dry eye symptoms. Punctum plugs are inserted by an eye care professional into the punctum of the eye so that tears do not drain as quickly.

Disclaimer: Please check with your doctor before starting any new supplements or medications. Before beginning new treatment or before considering changing your prescription, it is best to check with an eye care professional, and they will be able to determine if an eye exam during pregnancy is necessary.

Pregnancy can affect everyone differently, and at different stages. The body goes through a wide array of changes for months at a time. Since the symptoms can range from mild to severe, it’s important to manage any discomforting ocular symptoms early on, so that dry eyes won’t contribute to additional uncomfortable pregnancy symptoms. Dry eye and accompanying symptoms can cause a decrease in quality of life in general, depending on the severity of symptoms. And so, even outside of pregnancy, taking care of the eyes is incredibly important. Keeping the lids and lashes clean, hydrated, and comfortable is essential. Even after pregnancy, the hormones are re-stabilizing making it important to continue an ocular maintenance routine to ensure the symptoms don’t recur postpartum.


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[1] Asiedu, Kofi, et al. “Dry Eye, Its Clinical Subtypes and Associated Factors in Healthy Pregnancy: A Cross-Sectional Study.” PLOS ONE, vol. 16, no. 10, 7 Oct. 2021, p. e0258233, https://doi.org/10.1371/journal.pone.0258233.

[2] Sarikaya, Sevcan, and Yakup Acet. “The Effect of Pregnancy on Meibomian Gland, Tear Film, Cornea and Anterior Segment Parameters.” Photodiagnosis and Photodynamic Therapy, vol. 40, Dec. 2022, p. 103070, https://doi.org/10.1016/j.pdpdt.2022.103070.

[3] Bedinghaus, Troy . “Why Your Pregnancy May Cause Dry Eye Syndrome.” Verywell Health, 11 July 2022, www.verywellhealth.com/pregnancy-dry-eyes-maternity-eye-problems-3422022.

[4] Bedinghaus, Troy . “Why Your Pregnancy May Cause Dry Eye Syndrome.” Verywell Health, 11 July 2022, www.verywellhealth.com/pregnancy-dry-eyes-maternity-eye-problems-3422022.

[5] Alanazi, Mana Alafri, et al. “The Breastfeeding Effect on the Tear Film of Women: An Observational Study.” JPMA. The Journal of the Pakistan Medical Association, vol. 73, no. 11, 1 Nov. 2023, pp. 2200–2204, pubmed.ncbi.nlm.nih.gov/38013528/#:~:text=Significant%20moderate%20correlation%20was%20found, https://doi.org/10.47391/JPMA.8049.

[6] Yenerel, Nursal Melda, and Raciha Beril Küçümen. “Pregnancy and the Eye.” Turkish Journal of Ophthalmology, vol. 45, no. 5, 1 Oct. 2015, pp. 213–219, www.ncbi.nlm.nih.gov/pmc/articles/PMC5082244/, https://doi.org/10.4274/tjo.43815.

[7] Naureen M. Haroon. “Eye Care for Pregnant and Postpartum Patients.” Modern Optometry, Dec. 2022, modernod.com/articles/2022-nov-dec/eye-care-for-pregnant-and-postpartum-patients?c4src=article:infinite-scroll.