Treatment of glaucoma in pregnancy

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Date: November 2022, Version 3

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.

Benefits

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.

Risks

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.

Alternatives

Are there any alternatives to using glaucoma treatments?

No, glaucoma needs to be treated during pregnancy to prevent blindness.

No treatment

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 (MyBump Portal) allows women who are currently pregnant to create a secure record of their pregnancy, collected through a series of questionnaires. You will be asked to enter information about your health, whether or not you take any medicines, your pregnancy outcome and your child's development. 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 the MyBump Portal to register.

General information
Sadly, miscarriage and birth defects can occur in any pregnancy.

Miscarriage occurs in about 1 in every 5 pregnancies, and 1 in every 40 babies are born with a birth defect. This is called the ‘background risk’ and happens whether medication is taken or not.

Most medicines cross the placenta and reach the baby. For many medications this is not a problem. However, some medicines can affect a baby’s growth and development.

If you take regular medication and are planning to conceive, you should discuss whether your medicine is safe to continue with your doctor/health care team before becoming pregnant. If you have an unplanned pregnancy while taking a medicine, you should tell your doctor as soon as possible.

If a new medicine is suggested for you during pregnancy, please make sure that the person prescribing it knows that you are pregnant. If you have any concerns about a medicine, you can check with your doctor, midwife or pharmacist.

Our Bumps information leaflets provide information about the effects of medicines in pregnancy so that you can decide, together with your healthcare provider, what is best for you and your baby.

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