Pregnancy and blindness and vision impairment

Blindness or vision impairment can be challenging for women who are pregnant. Many women will have had issues with their vision for many years or their entire lives and some will not necessarily view this as a disability.

They will have been used to living with their particular condition and so the help needed by healthcare professionals when pregnant is related to getting the right support to ensure both they and their new-born baby is and remains safe. If their condition is genetic or hereditary they may have additional concerns about the impact on their new born.

It is possible for vision disturbance to be noticed during pregnancy, including dry eyes and blurred vision. These may be related to hormonal changes and are usually temporary, however should not be ignored and a healthcare professional should be consulted. More serious conditions can also lead to changes in vision during pregnancy including diabetes and pre eclampsia.

Defining vision impairment

Complete blindness: is the inability to see anything, including light. If diagnosed as partially blind, this means limited vision; for example, blurry vision or the inability to distinguish the shapes of objects. Any damage to the retina, such as a detached retina or artery occlusion, is a possible cause of sudden blindness. A detached retina can cause total loss of vision in the affected eye, or it may only result in partial vision loss, making it seem as if a curtain is blocking part of your vision.

Absolute blindness: defined as having “no light perception,” is rare. When someone suffers from absolute blindness, that person cannot tell the difference between light and dark, even when a bright light is shined into the eyes. Assistance from the government and foundations is available for persons suffering from this degree of blindness.

Legal blindness: refers to vision that's highly compromised, see: What does it mean to be legally blind? Most government agencies and health care institutions agree that legal blindness is defined as a visual acuity (central vision) of 20/20 or worse in the best seeing eye or a visual field (peripheral vision) that is limited to only 20 degrees. 

Vision impairment: is defined as having less than normal vision. 

Pregnancy and vision

Pregnancy can change vision by making eyes more sensitive to light, causing headaches or migraine pain. During pregnancy in some women, they may experience blurry vision or spots in front of their eyes. The most prominent reason for blurry vision is pregnancy hormones. They cause fluid retention which alters the cornea to make it thicker, along with an increase in the fluid pressure within the eyeball. This results in a blurred vision. (Increased progesterone levels during pregnancy can cause the tissues of the cornea to soften). This is often temporary. Usually, vision returns to normal when fluid retention is corrected and after giving birth. 

Care during pregnancy and childbirth needs to be planned according to need, and for women who have visual impairment this is even more important. Sadly, this care has been reported as being fragmented (RNIB, 2017) with not all finding positive support.   

Supporting women with limited vision

McEwen et al (1993) offered some practical advice on how best to support women with limited vision, including:

"A blind woman should be given an opportunity to touch the instruments to be used during an examination in order to reduce a fear of the unknown. Assisting her to palpate her abdomen, feeling the baby’s position and movements, and listen to the fetal heart with a Sonicaid Fetal Doppler will assist with prenatal attachment."

Some women may have a sighted partner, or their partner may also have visual impairment, she may have a guide dog, or may have a ‘sighted’ companion who will be able to assist her.

The most important message is to ask the woman what she needs, what her partner needs and what will work best for her.