Hormonal changes women experience during and after pregnancy can have effects on the eyes that can make LASIK outcomes less predictable. In some cases, these changes may be temporary but in others they can be permanent. Unfortunately there is no way to distinguish which cases are temporary. The exact mechanism of action is unknown, although it has been shown that changes in the corneal thickness and curvature occur, possibly due to swelling. Some have postulated that the same hormonal changes which allow for bodily changes to accommodate for growth of the baby within the woman’s body also allow for growth of the eye as well, leading to a change in prescription. If LASIK is performed and the prescription changes back after pregnancy or breastfeeding, the correction will no longer be appropriate and additional surgical correction will be needed. These changes also can affect healing of the eye after LASIK surgery.
Also, during and after LASIK surgery, several prescription and non-prescription medications typically are used by LASIK patients, and some of these might pose risks to a developing baby.
For example, on the day of surgery patients often are given a mild oral sedative (such as Valium) to relieve anxiety. And for several days after surgery, patients are instructed to use antibiotic and steroidal eye drops multiple times daily to prevent infection and reduce inflammation.
The effects of these medications on pregnant women are not fully known, and they might have the potential to cause harm to a developing baby when they enter the mother’s bloodstream.
For these reasons, most refractive surgeons advise their female patients to avoid having LASIK surgery during pregnancy and to wait a few months after they are done nursing their infant to have a vision correction procedure performed.
It’s also worth noting that many women experience dry eyes during pregnancy, which can make contact lens wear uncomfortable and even dangerous. If you are pregnant or are attempting to become pregnant, make sure you have an updated eyeglass prescription and glasses you can wear if you begin to experience dryness-related contact lens discomfort. Another concern in pregnancy and breastfeeding is the risk for the development or worsening of diabetes and other medical problems that can affect the health of the eyes. Additionally, pregnancy can cause significant blood pressure problems such as preeclampsia. These blood pressure- or diabetes-related problems can manifest in the eye. Patients can potentially present with bleeding or leaking blood vessels which can cause distortion of vision. Any changes of these kinds need to be handled very carefully to prevent long term damage to the eyes. These conditions can lead to an acute medical or surgical situation and the patient would definitely be precluded from having LASIK eye surgery. Other rare pregnancy related eye disorders can occur that induce swelling of the optic nerve or retina and can also be detected with a complete eye exam by an ophthalmologist.