Graefes Arch Clin Exp Ophthalmol

(2003) 241:484488 C L I N I C A L I N V E S T I G AT I O N
DOI 10.1007/s00417-003-0674-0

Louis D. Pizzarello Refractive changes in pregnancy

Received: 25 November 2002 Abstract Objective: To determine during pregnancy. Results: All
Revised: 20 March 2003 the causes of any vision change re- women who complained of visual
Accepted: 20 March 2003 ported during pregnancy. Setting: An changes were found to have experi-
Published online: 8 May 2003 obstetrical practice in Southampton, enced a myopic shift from pre-
Springer-Verlag 2003
New York. Study population: Two pregnancy levels. (0.870.3 diopters
hundred forty pregnant women were in the right eye (P<0.0001) and
L. D. Pizzarello ()
asked whether they had any altera- 0.980.3 diopters in the left eye
137 Hampton Road, tion in vision. Those who agreed to (P<0.0001). Post partum, all subjects
Southampton, NY 11968, USA take part in the study (83) and who returned to near pre-pregnancy levels
e-mail: bythebay@hamptons.com complained of vision changes (12) of myopia. Conclusions: This report
Tel.: +1-631-2835152 were matched with the next patient links worsening of myopia to preg-
Fax: +1-631-3251074
seen in the practice who was asymp- nancy. The causes of this myopic
L. D. Pizzarello tomatic. Observation: All patients shift are not readily evident and merit
Department of Ophthalmology, underwent a complete ophthalmic further investigation.
Southampton Hospital,
Southampton, New York, USA examination, including refraction.
Those who had alterations in vision
L. D. Pizzarello
E.S. Harkness Eye Institute, status were seen again after delivery.
Columbia University, New York, Main outcome measures Changes in
New York, USA visual acuity and refractive error

Introduction
Anecdotal reports of changes in vision during pregnancy
frequently are heard during residency training for obstet-
rics as well as ophthalmology. However, a review of the
literature in the area failed to reveal any studies that have
systematically looked at this issue. As part of a larger in-
vestigation into the role of pregnancy-related vision
change, the author undertook a casecontrol study of
pregnant women in a small community.
Materials and methods
The study group was selected from an obstetrical practice in
Southampton, New York. This is a community of 5,000 on Long
Island. The population is largely Caucasian and middle class. Ev-
ery woman presenting to the obstetrical practice with a new preg-
nancy was asked to take part in the study. All principles of the
Helsinki Declaration were followed. Those who agreed to partici-
pate answered a series of questions on a self-administered ques-
tionnaire. These dealt with demographic information, number of
pregnancies, history of eye disease, presence of any vision or ocu-
lar changes associated with the pregnancy, and use of any dietary
supplements. Any woman who reported a change in vision or had
any other ocular complaint was invited to have an eye examina-
tion. For each woman who agreed to take part and who had a visu-
al or ocular complaint, the next woman seen for obstetrical care in
the practice who agreed to take part in the study and who did not
have any visual or ocular symptoms was similarly invited to have
the ocular examination.
The author performed all ophthalmic examinations. Visual
acuity, both uncorrected and with current correction, was obtained
with Snellen optotype. The room had subdued lighting that was
kept constant for all examinations with a luminance of 17 cd/m2.
Manifest refraction was performed using trial lenses and streak
retinoscopy and the results recorded. The correction used prior to
pregnancy was also documented and confirmed by contacting the
previous ophthalmic or optometric practitioners. Ocular adnexa,
pupillary reflex, ocular motility, slit-lamp examination of the cor-