Dry Eyes and Pregnancy

Pregnant woman being counseled by her doctor. Hero Images

Question: Why do I have dry eyes now that I am pregnant?

"I've never had a problem with dry eyes. Now that I'm pregnant, my eyes bother me all the time. Both eyes feel very dry and scratchy, yet they water a lot." -- About.com User

Answer: Burning, scratchy eyes with excessive tearing is a tell-tale sign of dry eyes, or dry eye syndrome. Dry eye syndrome is a condition caused by a lack of moisture in the eyes, and it often shows up at times of hormonal change such as during pregnancy or breastfeeding.

Dry eye syndrome related to pregnancy usually worsens at the end of the first trimester due to massive hormonal changes. Dryness may seem to come and go throughout the day, and can be constant for some women.

Hormone changes can also affect the quality of the tears. 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. The meibomian glands line the upper and lower eyelid margins. One job of the meibomian glands is to secrete oil in the tears to prevent tear film evaporation. You may have a lot of tears, but they evaporate much faster than normal. This can create an unstable tear film and dry eyes. 

Dry eyes may continue throughout your pregnancy and can even persist for several months after you deliver. Mothers who choose to breastfeed their infants may continue to experience some dry eye symptoms due to some of the same type of hormonal changes that occur during pregnancy.

Symptoms may persist up a couple of months after lactation stops.

There are many ways to treat dry eye syndrome. 

  • Artificial tears - Artificial tears can be used to lessen the discomfort caused by dry eyes and are safe to use while pregnant or nursing. Artificial tears are available in many different types. One type that may be more helpful is one that replaces part of the lipid layer in the tears. Examples of these are Systance Balance by Alcon and Retain MGD Ophthalmic Emulsion by Ocusoft. If you wear contact lenses, make sure you choose an appropriate contact lens rewetting eye drops.
  • Warm compresses - Warm compresses on the eyes can open up and stimulate the meibomian glands. This brings blood flow to the area and restores the glands to normal. 
  • Punctal occlusion - If you visit your eye doctor with complaints of dry eyes, you will likely be informed about "plugging your tear ducts." Punctal occlusion is a painless procedure in which the puncta (small openings in the corners of the eyes through which tears drain) are blocked. Blocking the puncta increases the amount of tears available to bathe the front part of the eye by decreasing the amount of tears that drain away from the eye. Instead of plugging the gland that produces tears, punctal occlusion plugs the tear drainage pipe. (Think of plugging the drain in the kitchen sink -- the faucet still runs.) This procedure is safe for pregnant patients.

Sources:

Murkoff, Heidi and Sharon Mazel. What to Expect When You're Expecting, 4th Edition. Workman Publishing, 2008. Pp 242-243.

American Optometric Association. Dry Eye. AOA.org, 2006-09.

Continue Reading