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Management of Glaucoma in Pregnancy

Mathew, Sunu MBBS, DNB*; Harris, Alon MS, PhD, FARVO*; Ridenour, Colin M. MD*; Wirostko, Barbara M. MD, PhD; Burgett, Kendall M. BS*; Scripture, Molly D. BS*; Siesky, Brent MS, PhD*

doi: 10.1097/IJG.0000000000001324
Review Article
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Management of glaucoma during pregnancy represents a challenge for the physician. Important disease and patients’ health decisions begin even before conception and continue throughout pregnancy and breastfeeding. The 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 with a nonpregnant 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, and minimally invasive glaucoma surgery, represent nondrug 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 to explore current knowledge and guidelines in the management of glaucoma in pregnancy.

*Department of Ophthalmology, Indiana University School of Medicine, Eugene and Marilyn Glick Eye Institute, Indianapolis, IN

Moran Eye Center, Salt Lake City, UT

Disclosure: A.H. would like to disclose that he receives remuneration from Shire, CIPLA, and AdOM for serving as a consultant. A.H. also holds an ownership interest in AdOM and Oxymap. All relationships listed are pursuant to Indiana University policy on outside activities. The remaining authors declare no conflict of interest.

Reprints: Alon Harris, MS, PhD, FARVO, Department of Ophthalmology, Indiana University School of Medicine, Eugene and Marilyn Glick Eye Institute, 1160 West Michigan Street, Indianapolis, IN 46202 (e-mail: alharris@indiana.edu).

Received March 6, 2019

Accepted June 24, 2019

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