You can generally continue to wear contact lenses during pregnancy, but it is common to experience difficulties and discomfort. These changes are a direct result of the dramatic hormonal shifts and systemic fluid retention that occur throughout the body during gestation. Many people find their eyes become drier, their vision slightly altered, or their contact lenses simply do not feel comfortable anymore. The changes are almost always temporary and resolve after the baby is born.
How Pregnancy Hormones Affect Eye Physiology
The significant elevation of hormones like estrogen and progesterone causes widespread physiological changes, including alterations to the eye. These hormones contribute to systemic water retention, which affects the cornea. The cornea can absorb this extra fluid, leading to an increase in its thickness and a change in its overall curvature.
The hormonal environment also negatively impacts the tear film. Estrogen and progesterone can alter the balance of the tear film’s components (water, oil, and mucus layers). This disruption results in a less stable and less protective tear film, making the eye more vulnerable to irritation.
Common Vision and Comfort Changes
The physiological changes in the cornea and tear film result in noticeable symptoms for contact lens wearers. Increased corneal thickness and a steepening of the corneal curvature can cause a temporary shift in the eye’s refractive error, often resulting in a mild increase in nearsightedness. This means a person’s current contact lens prescription may no longer provide clear vision.
The altered corneal shape can also make existing contact lenses fit poorly, feeling tighter or rubbing uncomfortably. Simultaneously, the instability of the tear film often leads to severe dry eye syndrome, characterized by a gritty sensation, redness, and burning. This dryness is a major factor in contact lens intolerance, as the lenses rely on a healthy tear layer for lubrication and comfort.
Another common effect is increased sensitivity to light (photophobia), which compounds the discomfort experienced by those with dry eyes. About 15% of pregnant individuals notice some degree of vision change, with dry eyes typically becoming more prominent around mid-pregnancy. Any sudden or severe changes in vision should prompt an immediate call to an eye care professional, as they can sometimes indicate more serious underlying conditions.
Practical Strategies for Contact Lens Wear
If you are experiencing discomfort, schedule an appointment with your eye doctor to discuss the changes. They can assess the fit of your current lenses and confirm that the changes are benign and pregnancy-related. Since the underlying issue is often dry eye, using preservative-free artificial tears or lubricating drops frequently throughout the day can significantly improve comfort.
You may need to temporarily reduce the number of hours you wear your contacts or take more frequent breaks. Switching to daily disposable contact lenses is a good strategy, as a fresh, clean lens each day minimizes deposits and reduces the risk of irritation and infection.
If your vision has changed significantly due to corneal swelling or if the dryness is too severe, switching to glasses is the safest and most comfortable alternative. It is recommended to wait until after delivery to get a new contact lens or glasses prescription because the refractive changes are temporary. Any sudden onset of symptoms like double vision, flashes of light, or blind spots requires immediate medical attention.
What to Expect Postpartum
The ocular changes experienced during pregnancy are expected to reverse once the body’s hormonal and fluid levels return to normal. The cornea’s increased thickness and curvature will stabilize as the systemic fluid retention subsides. This resolution of symptoms typically occurs within a few weeks to a few months after delivery.
For people who breastfeed, the hormonal fluctuations may persist longer, which can slightly extend the timeline for the eyes to return to their baseline. Eye care providers usually advise waiting three to six months postpartum, or until after the cessation of breastfeeding, before undergoing a final eye exam for a new prescription. This ensures that any new glasses or contact lenses reflect a stable refractive correction.