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Pregnancy and Dry Eye Syndrome: A Review for Clinical Practice
Marta Jaruchowska1, Joanna Przybek-Skrzypecka2,3, Janusz Skrzypecki4
1ISPL Marta Jaruchowska, 13-200 Działdowo, Poland.
International Journal of Molecular Sciences
|October 29, 2025
Summary
Pregnancy may cause dry eye syndrome (DES) due to hormonal shifts, affecting up to 50% of expectant mothers. While symptoms are often mild, recognizing and managing DES is crucial for maternal comfort and eye health.
Area of Science:
- Ophthalmology
- Reproductive Medicine
- Physiological Adaptations During Pregnancy
Background:
- Pregnancy involves significant hormonal, metabolic, and immunological changes impacting ocular surface homeostasis.
- Dry eye syndrome (DES) is frequently observed during pregnancy, potentially linked to estrogen and progesterone fluctuations, insulin resistance, and immune tolerance.
- While DES affects 20-50% of pregnant women, particularly in the second and third trimesters, its status as a confirmed risk factor remains inconclusive.
Purpose of the Study:
- To review the pathophysiological mechanisms of DES in pregnancy.
- To outline diagnostic strategies and safe management options for pregnant individuals experiencing DES.
- To underscore the importance of awareness regarding DES among healthcare providers involved in prenatal and ophthalmic care.
Main Methods:
- Literature review of pathophysiological mechanisms, diagnostic approaches, and management strategies for DES in pregnancy.
- Synthesis of current evidence and consensus reports (e.g., TFOS DEWS III) on the relationship between pregnancy and DES.
- Emphasis on clinical implications and the need for increased provider awareness.
Main Results:
- Hormonal changes, particularly estrogen and progesterone, are key contributors to DES development or exacerbation during pregnancy.
- DES symptoms can negatively impact quality of life and prenatal care adherence, despite often being self-limiting.
- Current evidence, while biologically plausible, does not definitively establish pregnancy as a confirmed risk factor for DES.
Conclusions:
- Increased recognition of DES in pregnancy is essential for improving patient comfort and preventing potential long-term ocular complications.
- Collaborative awareness between obstetricians and ophthalmologists is vital for effective diagnosis and management of DES in pregnant patients.
- Further research may clarify the definitive role of pregnancy in DES etiology and progression.
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