title: Ocular changes during pregnancy.
abstract: BACKGROUND
  Most ocular changes in pregnancy are harmless. For example, 14% of pregnant women need a new eyeglass prescription. Some changes, however, are serious, such as retinal effects of hypertension, which can be a sign of pre-eclampsia. Ocular changes may give rise to uncertainty about the administration of ophthalmological drugs or the optimal method of childbirth.
  
  
  METHODS
  This review is based on pertinent literature retrieved by a selective search in Medline and on guidelines from Germany and abroad. Recommendations about drugs were taken from the Embryotox and Reprotox databases, the German Red List, and the United States Food and Drug Administration (FDA).
  
  
  RESULTS
  40% to 100% of pregnant women with high blood pressure have retinal changes whose severity is correlated with the severity of pre-eclampsia or eclampsia. Diabetic women should undergo ocular examination before and during pregnancy. Pre-existing retinal changes worsen during pregnancy in 55% of cases. Most ocular diseases can be treated with the usual drugs in pregnant women and nursing mothers, although the evidence for drug safety is derived from case series and the treatment is usually provided off label. Ocular conditions that are present before pregnancy are irrelevant to the choice of a method of childbirth.
  
  
  CONCLUSIONS
  Pregnant women and nursing mothers can undergo most types of ophthalmological examination and treatment. Recommendations about drug treatment should be checked against current information that can be found on the embryotox.de and reprotox.de websites.
authors.affiliation: Interdisciplinary Uveitis Center, Department of Ophthalmology, University of Heidelberg, Institute of Reproductive Toxicology Ravensburg, Department of Internal Medicine V, Department of Ophthalmology, University of Freiburg i. Brsg.
authors.forename: Friederike
authors.initials: F
authors.lastname: Mackensen
authors.forename: Wolfgang E
authors.initials: WE
authors.lastname: Paulus
authors.forename: Regina
authors.initials: R
authors.lastname: Max
authors.forename: Thomas
authors.initials: T
authors.lastname: Ness
mesh_terms: D003941:Diagnostic Techniques, Ophthalmological / Q000592:standards*; D005128:Eye Diseases / Q000175:diagnosis* / Q000628:therapy*; D005260:Female; D006801:Humans; D017410:Practice Guidelines as Topic; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000628:therapy*