Treatment of glaucoma in pregnancy
(Date: November 2022. Version: 3)
This factsheet has been written for members of the public by the UK Teratology Information Service (UKTIS). UKTIS is a not-for-profit organisation funded by the UK Health Security Agency (UKHSA) on behalf of UK Health Departments. UKTIS has been providing scientific information to health care providers since 1983 on the effects that medicines, recreational drugs and chemicals may have on the developing baby during pregnancy.
What is it?
Glaucoma is an eye disease where high fluid levels in the eyeball lead to increased pressure. This can damage the optic nerve leading to vision loss.
How is glaucoma treated?
A number of medicines are used to treat glaucoma:
The most common are groups of drugs called prostaglandin analogues (such as latanoprost, bimatoprost, travoprost and tafluprost) or beta-blockers (such as timolol, betaxolol, carteolol, and levobunolol).
Other medicines used to treat glaucoma include brimonidine, apraclonidine, pilocarpine, acetazolamide, brinzolamide, and dorzolamide.
These drugs work by reducing the pressure in the eye. Most are given as eye drops, although very occasionally, acetazolamide is given in tablet form. Some people might require a combination of medicines to fully control their glaucoma.
What are the benefits of using glaucoma treatments in pregnancy?
Use of glaucoma treatments can help to prevent eyesight problems (including blindness). Women with glaucoma will therefore be advised to continue treatment during pregnancy.
Women who are planning a pregnancy or who become pregnant should be offered a treatment review to ensure that they are using the most suitable drug.
Are there any risks of using glaucoma treatments during pregnancy?
Medicines in eyedrops generally enter the bloodstream in small amounts. Only a small number of pregnant women using glaucoma treatments have been studied, but overall, there is no concern that their use causes any serious or long-term problems in the baby.
In rare cases when eyedrops do not work, laser treatment or an operation may be required to treat glaucoma. These procedures may occasionally be offered during pregnancy if there is a chance that a delay might lead to vision loss.
Any theoretical risk is generally outweighed by the benefit of using these drugs and treatments to preserve eyesight.
Are there any alternatives to using glaucoma treatments?
No, glaucoma needs to be treated during pregnancy to prevent blindness.
What if I prefer not to take medicines to treat glaucoma?
It very important that glaucoma medicines are continued during pregnancy as stopping treatment can cause permanent sight damage.
Your doctor will only prescribe medicines when absolutely necessary and will be happy to talk to you about any concerns.
Will my baby need extra monitoring?
Most women will be offered a scan at around 20 weeks of pregnancy to check their baby’s wellbeing as part of their routine antenatal care. Using glaucoma treatments in pregnancy is not expected to cause problems that would require extra monitoring.
Are there any risks to my baby if the father used glaucoma treatments?
We would not expect any increased risk if the father used glaucoma treatments before or around the time you became pregnant.
Who can I talk to if I have questions?
If you have any questions regarding the information in this leaflet please discuss them with your health care provider. They can access more detailed medical and scientific information from www.uktis.org.
How can I help to improve drug safety information for pregnant women in the future?
Our online reporting system allows women with a current or previous pregnancy to create a digitally secure ‘my bumps record’. You will be asked to enter information about your health, whether or not you take any medicines, and your pregnancy outcome. You can update your details at any time during pregnancy or afterwards. This information will help us better understand how medicines affect the health of pregnant women and their babies. Please visit www.medicinesinpregnancy.org/Login/. to register
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General information
Up to 1 out of every 5 pregnancies ends in a miscarriage, and 1 in 40 babies are born with a birth defect. These are referred to as the background population risks. They describe the chance of these events happening for any pregnancy before taking factors such as the mother’s health during pregnancy, her lifestyle, medicines she takes and the genetic make up of her and the baby’s father into account.
Medicines use in pregnancy
Most medicines used by the mother will cross the placenta and reach the baby. Sometimes this may have beneficial effects for the baby. There are, however, some medicines that can harm a baby’s normal development. How a medicine affects a baby may depend on the stage of pregnancy when the medicine is taken. If you are on regular medication you should discuss these effects with your doctor/health care team before becoming pregnant.
If a new medicine is suggested for you during pregnancy, please ensure the doctor or health care professional treating you is aware of your pregnancy.
When deciding whether or not to use a medicine in pregnancy you need to weigh up how the medicine might improve your and/or your unborn baby’s health against any possible problems that the drug may cause. Our bumps leaflets are written to provide you with a summary of what is known about use of a specific medicine in pregnancy so that you can decide together with your health care provider what is best for you and your baby.
Every pregnancy is unique. The decision to start, stop, continue or change a prescribed medicine before or during pregnancy should be made in consultation with your health care provider. It is very helpful if you can record all your medication taken in pregnancy in your hand held maternity records.
www.medicinesinpregnancy.org