So you’re having a baby—congratulations! This new and exciting time can also be a bit intimidating. As you likely know, pregnancy causes all sorts of bodily changes besides just the size of your stomach—believe it or not, this includes the eyes too!

During pregnancy, expecting mothers can experience water retention, hormonal changes, vascular changes, endocrine changes, and many more!

While there have been dozens of ocular manifestations documented during pregnancy, we’ll focus on the three most common changes here in this article—increased pigmentation around the eyes and face, eye dryness, and changes in glasses prescription.

Chloasma (Pigmentation)

Pregnancy can cause increased pigmentation around, or even within, the eyes.

This is a cosmetic concern many expecting mothers face during pregnancy—will these dark spots on my face ever disappear, or will I have dark patches on my face for life?

The answer is yes, the patches will likely disappear with time, but it may take several months.

The appearance of dark patches on the face, especially on the cheeks and eye region, is medically known as Chloasma, or more commonly the “mask of pregnancy”.

During pregnancy, especially in the second and third trimesters, there is a significant increase in the amount of hormones estrogen and progesterone. These hormones are necessary for blood vessel development, nutrient supply, and structural support in a developing fetus.

However, these hormones also play other roles throughout the body. Upregulation of estrogen stimulates cells called melanocytes (the pigment-producing cells of the body) to increase production of melanin.

Melanin is the source of darkly colored pigmentation throughout the body. More melanin means more pigment, and thus dark patches are created.

This pigmentation can occur anywhere, as melanocytes are found throughout the body, but, for whatever reason, tends to deposit most commonly on face (cheeks, chin, under the eyes, etc.), belly, armpits, and breasts.

Sometimes an individual’s eye color may even change secondary to this increase in melanin, as melanin is the underlying factor for creation of eye color!

Yes, that’s right! Sometimes during pregnancy an individual’s eye color will darken, turning from hazel to brown, green to hazel, etc.

UV exposure is thought to play some role in the exacerbation of this melanin deposition in at least the facial region, and therefore if chloasma is a concern for you, approved sunscreen, hats, and sunglasses may offer some protection against further pigment development.

After giving birth, when estrogen levels begin to level out, the body will often times slowly reabsorb the melanin produced when estrogen levels were elevated. This process occurs naturally and typically occurs between 6-12 months post-partum.

Chloasma is not painful, itchy, or scaly. It is simply just the appearance of more pigmentation.

While chloasma may cause cosmetic concerns, it does not have health implications or mean that something is amiss with your pregnancy. However, you should always speak with your OBGYN if you have questions or concerns.

Pregnancy Can Cause Dry Eye

Hormones wreak havoc on everything, this includes the eyes!

Changes in hormonal makeup can alter the quality and quantity of tears your eyes produce, resulting in dry eye.

It is currently hypothesized that increased levels of the hormone prolactin are responsible for this change, although the exact mechanism as to why tear quality changes is unknown.

Not only that, but it is also easy to become dehydrated when pregnant—you are expending extra resources growing another human after all!

What we do know, is that in many pregnant individuals’ tears are not produced properly.

When we have a lack of tears covering the eyes, an individual may experience symptoms of irritation, redness, burning, grittiness, intermittently blurry vision, and even sensitivity within the eyes and around the eyelid margins.

Contact lenses, certain makeup products, and just doing normal activities of daily life may become difficult and uncomfortable.

Preservative-free artificial tears and warm compresses will likely provide the relief needed to get through this time.

Eye dryness may or may not resolve post-partum, but fortunately it is an up-and-coming problem getting a lot of attention by researchers world-wide, and treatment options for dry eye does exist.

Start by making an appointment with your favorite eye doctor today, and he/she will be able to make the best recommendations based on your current situation and help find the relief you need—you do not need to suffer through dry eye in silence!

Changing Eye Prescription

During pregnancy, the body naturally retains more water.

Water retention results in swelling of different parts of the body most commonly affecting the ankles, feet, hands, face, and eyes.

Swelling of the eyes can occur in two major areas—the lens and the cornea—both of which are responsible for the refraction of light.

Vision works through proper refraction of light so that incoming light rays come to a point source on the backmost structure of the eye, the retina.

The cornea and the lens are the two largest refracting components of light refraction.

If the cornea and/or lens swells due to excess water in the body, it will refract light differently than in a non-swollen matter. In this state, light rays may not come to a focus point on the retina, but instead in front of or behind the retina, creating blur.

This swelling is not a permanent change, however, and the amount of swelling can vary from day-to-day, or even hour-to-hour.

For this reason, there really is not a great solution for improving vision. Glasses can be expensive and the prescription will likely change based on the amount of swelling. For this reason, most eye doctors will recommend holding off on a new prescription until after the baby is born.

With time, the swelling will go down and an individual’s prescription will stabilize, most often by 6 months post-partum.

However, again there is no need to suffer through poor vision throughout pregnancy. Always call your optometrist with questions or concerns with your eyes. We are happy to help all of our patients, especially our mothers-to-be!

Dr. Anthony Spina and the staff of Premier Eye Associates specialize in glasses, soft contact lenses, hard contact lenses, and medical eye exams. Call our eye doctor in Auburn, AL today at (334) 539-5391 or schedule an appointment online  if you have any concerns or questions on how your pregnancy is affecting your eyes.  Our optometrist provides only the highest quality eye care services amongst eye doctors in the Auburn Alabama area.