Providing eyecare that serves the needs of women who are pregnant or experiencing other hormonal changes meets a vital need and projects a family-friendly message.
Women sometimes have eyecare challenges that differ from men due to the hormonal changes that they experience during pregnancy and at other times in their life such as through the use of contraceptive pills and during menopause. High-quality artificial tears and switching to a new silicone hydrogel daily replacement lens will become important to prevent excessive inflammation or irritation.
Many of your patients will experience similar symptoms due to hormonal changes. Here are some key points to consider about keeping women’s eyes comfortable through hormonal changes including pregnancy.
In Exam Room: Educate and Reassure Patient
In order not to assume anything, do not address pregnancy eyecare concerns until a woman has told me she is pregnant or asks about it on her own before then. Reassure the patient that pregnancy usually doesn’t cause major issues with eye health, but for those issues you do see, it usually has to do with contact lens intolerance due to hormonal changes in the tears and ocular tissues (most likely) or minor prescription changes that may or may not be permanent. The biggest concern is the development of gestational diabetes and potential diabetic retinopathy.
It’s good to let them know, however, that breastfeeding may extend the issues, but regardless, the benefits for the baby’s eye development through breast milk are fantastic! There are significant brain development advantages to breast milk. It is common for baby formulas to advertise that their brand offers all the necessary nutrients for eye and brain development. Breast milk is even better than those formulas as it naturally contains all of those nutrients. Since 30 percent of our overall brain function is dedicated to vision, the same nutrients in breast milk that enhance brain function also, therefore, are beneficial to the infant’s vision.
Added Precautions Recommended for Pregnant Patients
Don’t dilate pregnant or nursing women unless there is a prominent need to do so to adequately check the health of the eye (for instance, diabetes, risk of retinal detachment, or any other sight-threatening condition). In those cases, have them use punctal occlusion to limit systemic absorption. Rarely, you would come across situations of red eye/infections.
Conceptive Pills Also Cause Hormonal Changes
Even before women become pregnant, they may be experiencing eye discomfort related to the kind of birth control pills they are taking. If a woman has a sudden change in experiencing dry eye, or notices a pattern of dryness throughout the month, that is a flag to ask questions about what type of birth control she is on (it seems to be better with monocyclic brands than tricyclic because the monocyclic pills provide a steady dose of hormones whereas the tricyclic pills change hormone levels weekly and can be more problematic for SOME women).
Opportunity to Begin Education About Pediatric Eyecare
Become active in the InfantSEE program. Tell your pregnant patients about the program as a “gift to them and their baby” as the comprehensive exam is complimentary. As long as the baby is developing normally, they should have an eye exam in the first six to 12 months, again between ages 3-4, and every year thereafter. If there is a problem, there will be more exams scheduled. You should have a bulletin board in your office dedicated to taking pictures with the infants and then posting them up (with parents’ permission). It’s a great conversation piece and helps to educate others about the program.
Make sure you have the HIPAA Marketing Release Form signed before using marketing materials featuring patients.