Management of Glaucoma in Pregnancy

Abstract

Management of glaucoma during pregnancy represents a challenge for the physician. Important disease and patient health decisions begin even prior to conception and continue throughout pregnancy and breastfeeding. Data on this topic is limited due to ethical and legal constraints and challenges of conducting large, prospective, and randomized clinical trials on this patient population. Our review suggests that individually, intraocular pressure is lower in a pregnant woman when compared to a non-pregnant woman. Importantly, the medical management of glaucoma during pregnancy poses special challenges due to the possibility of adverse effects of medications on the fetus and newborn. Laser trabeculoplasty and traditional filtration surgery, as well as minimally invasive glaucoma surgery, represent non-drug management options. Thus, managing glaucoma in pregnancy is a delicate balance between treatment to prevent damage to the optic nerve in the mother and avoidance of interventions potentially harmful to the fetus. This literature review of published individual and population-based studies was performed in order to explore current knowledge and guidelines in the management of glaucoma in pregnancy.