Question:
I have heard that pregnant women should not have eye exams until after the birth because hormonal changes can effect vision, is this true? Or is this some old wives tale? What about fundus examinations? Can it harm an unborn child?
The only reason why I asked is because I had a pregnant patinet ask about fundus exams. It appears that the safety of it has not yet been confirmed.
Precautions: Measurement of the depth of the angle of the anterior chamber should be obtained prior to administration of homatropine to patients with a predisposition to glaucoma.
Excessive ophthalmic use, especially in children and the elderly, may produce systemic symptoms of atropine poisoning. Do not exceed recommended dosage. Not for frequent or prolonged use. If dryness of the mouth occurs, decrease dosage. Discontinue use if rapid pulse or dizziness occurs. Homatropine may cause an increase in intraocular pressure. If eye pain occurs, discontinue use immediately as this may indicate undiagnosed glaucoma.
Pregnancy: Safety has not been established.
Lactation: Documentation is lacking or conflicting regarding the excretion of anticholinergics (especially atropine) in breast milk and the reduction in breast milk production caused by these drugs. Although there is no documentation of adverse effects in breast-fed infants, it is advisable to closely monitor infants of nursing mothers for anticholinergic side effects.
Answer:
I am old enough to have fit a lot of good ole' PMMA lenses. And yes I did see fitting changes in about 25% of the pregnant women I saw. About half of these were permanent changes and about half went back to normal after 3 months post-partum.
Once upon a time we even blamed birth control pills for most of our troubles (at that time 90% of the women over 14 than I asked, were on the pill and I didn't ask the ones under 14. The only problems I found were rare and confined to the first 3 months on or the first 3 months off the pill.
