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Bad Vision in Pregnancy

The human cornea must be mechanically stable as a structure. One speaks of the biomechanics of the cornea. In recent years there is increasing evidence that hormones, especially during pregnancy, can negatively affect corneal biomechanics. Our group is one of the international pioneers of this branch of research.

Harmless changes in vision during pregnancy

During pregnancy, many alterations take place in the human body. It has been known for decades that a so-called “myopic shift” takes place in late pregnancy, so the human eye becomes more short-sighted. The causes of this are not yet fully understood, but it is believed that the cornea in late pregnancy stores water and thereby changes their refractive index. These hermetic changes usually return in the first months after pregnancy

Oestrogen

It has been known for a number of years now that oestrogen can directly affect the cornea. Increased oestrogen levels during pregnancy can have a direct impact on the biomechanical stability of the cornea. In other words, the cornea becomes “softer” at the end of the pregnancy. This can have a number of consequences.

  • Keratoconus: pregnancy can worsen existing keratoconus. Our group has already published on this topic years ago.
  • Post-LASIK ectasia: our research group was one of the first to report cases of patients who underwent LASIK, who showed excellent results and good vision for years after LASIK… until they became pregnant. During pregnancy, these women then developed post-LASIK ectasia. This is very similar to keratoconus, and is the most threatening complication after LASIK / PRK. These cases demonstrate the importance of the surgeon’s experience in assessing patient’s suitability for undergoing LASIK. Also, the surgeon must be very familiar with the topic of biomechanics of the cornea.
 

Thyroid

There is increasing evidence that the under-production of thyroid stimulating hormone, TSH, has a direct impact on the biomechanics of the cornea and therefore, good vision. Our research group has been a trailblazer here; read more about our work here.

Our research on this topic

Corneal biomechanics during pregnancy

Journal of Cataract and Refractive Surgery. Research letter discussing the effect of pregnancy and oestrogen on the biomechanical stability of ...

Video Interview on hormonal corneal changes at WOC Tokyo 2014

Interview on the effect of pregnancy and thyroid disease on the cornea at the World Ophthalmology Congress in Tokyo ...

The PowerList 2014

The Ophthalmologist. In 2014, the readers of "The Ophthalmologist" voted for the PowerList, the 100 most influential personalities in global ...

2014. World Ophthalmology Congress (WOC).

Tokyo, Japan. Farhad Hafezi, Invited speaker. See the program here ...

Keratoconus during pregnancy

Journal of Refractive Surgery. ELZA shows that the cornea of a person suffering from keratoconus may show massive estrogen-related changes ...

Pregnancy may be risk factor for late-onset post-LASIK ectasia

Ocular Surgery News Europe Edition. Cases have been reported up to 9 years after refractive surgery, once the patient became ...

Pregnancy may be a risk factor after LASIK

Journal of Refractive Surgery. ELZA members show that pregnancy may lead to corneal complications, even years after LASIK, if proper ...

Estrogen’s impact on the cornea

EyeWorld Read here ...

Pregnancy exacerbates iatrogenic keratectasia

Journal of Cataract and Refractive Surgery. The very first report on the use of CXL to halt ectasia that was ...
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