ELZA was represented at the 86th SBAO Symposium in Bern held last weekend by our Consultant Oculoplastic surgeon, Dr. Dr. Dion Paridaens.
During pregnancy, elevated levels of estrogen, progesterone, relaxin, and other hormones lead to physiological changes that include fluid retention, altered collagen metabolism, and increased corneal thickness. These changes may result in:
In healthy eyes, these changes usually resolve after childbirth. However, in eyes with underlying biomechanical fragility – such as those affected by keratoconus – pregnancy can contribute to disease progression. Hormone-mediated alterations in corneal collagen structure and hydration may reduce the structural stability of the cornea, particularly in the third trimester.
While keratoconus is a chronic, progressive condition, pregnancy may accelerate its course, particularly in younger patients or in those with previously undiagnosed disease. Case reports and small clinical studies suggest a higher risk of progression during and shortly after pregnancy, with increased steepening or corneal thinning noted on topography.
For patients already diagnosed with keratoconus, it is important to monitor corneal shape and vision during pregnancy. In those with borderline cases or subtle irregular astigmatism, pregnancy may be the period during which biomechanical changes first become clinically detectable.
Pregnancy also influences thyroid function, and thyroid hormone levels play a role in maintaining corneal health and biomechanical stability. Disruptions in thyroid function – whether due to gestational thyroiditis, pre-existing hypothyroidism, or hyperthyroidism – may influence collagen metabolism and corneal structure.
Recent studies suggest that altered thyroid function may be associated with changes in corneal curvature, thickness, and topography, and in rare cases, may contribute to or mimic keratoconus-like changes. At ELZA, we take thyroid function into account when assessing unexplained corneal changes in pregnancy.
For more information, visit our page on thyroid and the cornea.
If you are pregnant and have a history of keratoconus or irregular astigmatism – or if you notice changes in your vision during pregnancy – we recommend a corneal topography exam. This non-invasive imaging can detect subtle shape changes and guide decisions about monitoring or future treatment.
At the ELZA Institute, we use advanced diagnostic tools to assess corneal biomechanics and shape. Our team works closely with obstetric and endocrine specialists when pregnancy-associated ocular changes are suspected to be linked to systemic hormone shifts.
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