Glaucoma treatment in pregnancy and lactation: A literature review

Introduction: Intraocular pressure (IOP) in pregnancy decreases slightly towards the 18th gestation week, however in pregnant patients with glau-coma or ocular hypertension the IOP could be variable and will not ne-cessarily be reduced. Therefore, some pregnant women require potentially risky treatment for them and their fetuses.Objective: To describe the relevant ocular physiopathological changes, management options and possible adverse effects of treatment during pregnancy and lactation in patients with associated glaucoma.Materials and methods: A literature review of publications was carried out from 2001 to 2021, considering the corresponding MeSH terms for glaucoma, pregnancy, lactation, and intraocular pressure (IOP). In a structu-red way, the information was extracted and synthesized.Results: It is increasingly common to identify pregnant patients with glau-coma. This condition can be treated with topical medications, but most of those are category C. The treatment option with selective laser trabeculo-plasty seems to be a safe treatment, but the evidence is limited. Glaucoma surgery is an option in case of poor IOP control and visual function dete-rioration. The use of antimetabolites is fully contraindicated in this group of patients. During lactation, it is necessary to adjust topical medications, considering the conditions of the newborn.Conclusions: The approach to glaucoma in the pregnant patient requi-res a precise balance between IOP control to prevent visual damage in the pregnant/lactating female and the prevention of adverse effects in the fe-tus/newborn.