How pregnancy can affect your vision

If you’re pregnant, you’re already experiencing a lot of new changes to your body. Changes to your vision is something you might not expect; you can thank your changing hormones for that. The increased levels of hormones can affect tissues and organs throughout your body, including your eyes. In most cases, the changes are temporary and treatable. There are times when certain eye problems or vision changes during pregnancy may indicate a more serious condition.

Learn what vision issues may arise when you’re expecting, why it happens, and when you should see your eye care provider.

There’s an endless amount of information available about morning sickness, fatigue and mood swings during pregnancy. However, many women have no idea that they might also experience vision changes during pregnancy and that these problems can go on for weeks after delivery.

“Changes in vision happen because of hormonal shifts and fluid retention. These typically happen in the second and third trimesters,” says Jennifer Tsai, O.D., an optometrist and founder of Line of Sight, a private eyecare practice and optical boutique in New York City.

During pregnancy, as hormones change, the body produces more fluid to support the developing baby.¹ “Just like you can have swollen hands and feet, the corneal tissue around your eyes can swell due to water retention,” Tsai says. Excess fluid can also affect the thickness, shape, and sensitivity of your cornea. That’s the curved outer part of your eye that covers your iris and pupil.

Your retinas (the back part of the eye) can also be affected by pregnancy. That’s because of the increase in blood volume, which can almost double during pregnancy.² A greater amount of blood in the body can cause blood vessels in the retina to leak fluid. That, in turn, causes retinal swelling and your vision to become blurred.

High blood pressure, also known as hypertension, can play a role in vision problems during pregnancy.³ Higher than normal blood pressure may cause blurry vision or spots in front of the eyes. At excessive levels, hypertension can even cause retinal detachment.

It’s important to know that pregnant women with high blood pressure can also suffer vision changes because of preeclampsia and eclampsia. Those are potentially dangerous conditions that can happen during pregnancy.

Preeclampsia usually begins after the 20th week and is a condition in which a pregnant woman develops:

• High blood pressure
• High levels of protein in the urine
• Swelling of the legs, hands, face or entire body

If preeclampsia becomes severe, it can pose dangerous complications such as organ damage, stroke or other brain injury.⁴ According to the March of Dimes, common vision changes that can happen in preeclampsia include flashes of light, auras, light sensitivity, blurriness or seeing spots.

Eclampsia is very rare. It happens when a pregnant woman with preeclampsia starts having seizures or falls into a coma. In addition to the vision symptoms of preeclampsia, eclampsia can also bring double vision, vision loss and missing areas in one’s visual field.

Both preeclampsia and eclampsia can continue after delivery or even develop postpartum.

Women with diabetes, or those who develop gestational diabetes, are susceptible to vision changes during pregnancy. Those may include blurred vision, dark spots and floaters. Pregnancy can increase the pressure on blood vessels in your eyes. This could increase your chances of diabetes-associated eye conditions, especially if you had signs of eye damage before getting pregnant, according to the American Diabetes Association (ADA).⁵

One of those eye conditions is diabetic retinopathy. It affects blood vessels in the retina and can result in vision loss or blindness. Per the National Eye Institute, having diabetes makes you 2 to 5 times more likely to develop cataracts. It also doubles your risk of developing a type of glaucoma called open-angle glaucoma.⁶ The ADA recommends that pregnant women with diabetes have their vision examined within the first trimester and again in the third trimester. Pregnancies in women with diabetes are considered high-risk — so if you have diabetes, it’s important to make sure you work with your health care providers to monitor the situation.

Women with myopia (nearsightedness) may also be more likely to see their vision worsen. That is because of water retention in the cornea, says Juanita Collier, O.D., an optometrist in Cromwell, Connecticut, and founder of 4D Vision Gym, a private optometric vision therapy practice. Nearsightedness means objects up close are clearer than those farther away, and vision is blurred when you look at things in the distance. Women may notice it in the second and third trimesters when fluid retention is the most prominent, says Tsai.

Some studies have shown that women can develop nearsightedness while pregnant. The good news is that it tends to disappear after pregnancy. A 2022 study by researchers at the University of Gondor in Ethiopia found that myopia was twice as likely to occur in the third trimester and was associated with increased maternal age.⁷

“This is the most common change in vision during pregnancy,” says Tsai. Fluid retention can cause the lens of your eye — the part that allows the eye to focus — to change shape. That negatively affects visual acuity. Extra fluid can also change the shape and thickness of your cornea. That, in turn, can distort your sight.

If blurry vision is interfering with your daily tasks, see your eye care provider. They may be able to prescribe you glasses to improve your vision. 

Pregnancy-related blurriness is temporary and is rarely something to worry about. It should resolve itself within a few weeks of childbirth.

Dry eye occurs when there’s not enough moisture to keep the eyes wet. “During pregnancy, your tear production slows down,” says Tsai. That leads to symptoms such as:

• Blurry vision
• Burning
• Redness
• Scratchiness
• Stinging
• Sensitivity to light

A study published in 2021 in PLoS One found that nearly 41% of pregnant women suffered from dry eye during their pregnancy.⁸

You can try treating your dry eye with over-the-counter (OTC) artificial tear drops. Be sure to use drops that are saline or preservative free, advises Collier. “Stay away from any OTC drops that contain chemicals. Any drops you put into your eyes could enter your bloodstream and potentially that of the baby,” she says.

Other ways to help ease dry eye include:

• Blinking more frequently
• Staying hydrated
• Taking breaks from your smartphone, computer or tablet
• Using a humidifier at home

Your tear production should return after pregnancy, says Tsai. If dry eye continues after birth, address it with your eye care provider. They may suggest prescription lubricating drops. It’s important to not ignore this condition, if left untreated, dry eye can lead to tissue damage and scarring that can impair vision.⁹

Pregnant women may find that they have puffiness on their eyelids or around their eyes. It’s likely the result of hormones and water retention. It’s usually nothing to worry about, and it tends to go away in a day or so. However, if your puffiness is severe and accompanied by signs of preeclampsia, such as a severe headache, nausea, vomiting or shortness of breath, contact your primary care provider.¹⁰

To alleviate puffiness, Tsai recommends applying a cool compress to your eyelids and sleeping with your head elevated. Reducing your salt intake can also help reduce eye swelling.

Light sensitivity is when light causes discomfort or eye pain. Having dry eye can be a cause of light sensitivity, but it can also be a side effect of migraine headaches, which are common in pregnant women.¹¹ Migraines can also bring on blurry vision and blind spots.

See your eye care provider if you’re experiencing eye pain, suffering from migraines or just want peace of mind. There can be other causes of light sensitivity, too, such as a scratch on the cornea, cataracts or Graves’ disease.

You can try easing light sensitivity by closing your eyes, wearing ultraviolet-protective sunglasses while outside, and dimming the lights or darkening your room.

Pregnant women who wear contact lenses may be caught off-guard when their lenses suddenly cause problems, particularly in the third trimester. “The discomfort is usually because of water retention in the cornea and eye dryness from hormonal changes,” says Collier. “The swelling from water retention can make your lenses fit more tightly and feel dryer.”

Fortunately, the changes to your cornea aren’t permanent, says Collier. The lenses should fit better after the extra fluid goes down. Reducing the amount of time that you wear your contact lenses, or switching to wearing glasses, might be a good solution if your contacts are giving you problems.

Pregnancy is an exciting time, but it also brings some undesirable side effects, including potential vision changes. Knowing that most pregnancy-related eye changes are minor, temporary, and typically return to normal a few weeks after delivery can help ease worry and allow you to fully experience the joys of being a new mother.