Managing Glaucoma Medications During Pregnancy: Safety and Alternatives

Q: Managing Glaucoma Medications During Pregnancy: Safety and Alternatives

I recommend that you： 1. <br>Discuss the above situation further with your attending physician to determine if any additional tests are necessary. <br>2. <br>You may also consider visiting a major hospital or medical center for evaluation. <br>Thank you, and wish you good health!

Medications for glaucoma during pregnancy?

During pregnancy, is it safe to use glaucoma medications? If so, which ones can be used? Initially, I was using Alphagan (brimonidine), but I later found that it exacerbated my pre-existing dry mouth condition, ultimately leading to severe swelling of the salivary glands and blockage of the salivary duct.
After discussing with my doctor, I switched to Cosopt (dorzolamide/timolol), and it took seven months and a significant amount of money to improve the swelling of my salivary glands, which was extremely painful.
Now, I am very afraid to use Alphagan again.
Can I continue using Cosopt during pregnancy, or should I switch to another medication or stop altogether? My previous visual field tests have confirmed that my vision has been affected.
Additionally, I often experience severe pain deep in my eye socket, not on the surface of the eye, but deep below the eyeball.
Sometimes the pain is so intense that I feel an urge to dig into my eye.
However, when I previously asked my doctor about this, he said that I have normal eye pressure glaucoma, so eye pain is not possible unless the eye pressure is very high.
Yet, I frequently experience this deep pain in my eye socket.
What could be the cause? Thank you for your response, doctor.

L, 40~49 year old female. Ask Date: 2022/08/25

Dr. Liang Ce reply Ophthalmology

I recommend that you: 1.
Discuss the above situation further with your attending physician to determine if any additional tests are necessary.
2.
You may also consider visiting a major hospital or medical center for evaluation.
Thank you, and wish you good health!

Reply Date: 2022/08/25

More Info

Managing glaucoma during pregnancy can be quite challenging, especially when considering the safety of medications for both the mother and the developing fetus. It is crucial to consult with a healthcare provider who specializes in both obstetrics and ophthalmology to ensure the best outcomes.

First, let's address the safety of glaucoma medications during pregnancy. The American Academy of Ophthalmology categorizes medications based on their safety profiles during pregnancy. Some medications used to treat glaucoma, such as prostaglandin analogs (e.g., latanoprost), are generally considered to have a low risk of adverse effects on the fetus, but they should still be used with caution. Other medications, such as beta-blockers (e.g., timolol), may also be prescribed, but they can potentially affect fetal heart rate and should be monitored closely.

In your case, you mentioned using "艾弗目" (likely referring to a medication like brimonidine) which has been associated with adverse effects such as dry mouth and could exacerbate existing conditions like salivary gland issues. If this medication has caused significant side effects for you, it is understandable that you would be hesitant to use it again, especially during pregnancy.
You also mentioned switching to "舒而坦" (possibly referring to a different class of glaucoma medication), which may have provided relief without the severe side effects you experienced previously. It is essential to discuss with your doctor whether this medication is safe to continue during pregnancy. Some medications may need to be adjusted or switched to alternatives that are safer for use during pregnancy.

Regarding your symptoms of deep eye socket pain, it is important to differentiate between pain caused by glaucoma and other potential causes. While elevated intraocular pressure (IOP) is a common cause of pain in glaucoma, it is not the only factor. Pain in the eye socket can also be due to other conditions such as sinus issues, migraines, or even referred pain from other areas. A thorough examination by an ophthalmologist is necessary to determine the exact cause of your pain and to ensure that your glaucoma is being managed effectively.

In summary, managing glaucoma during pregnancy requires careful consideration of the medications used and their potential effects on both the mother and the fetus. It is crucial to work closely with your healthcare provider to monitor your condition and adjust medications as needed. If you have concerns about specific medications or side effects, do not hesitate to bring them up during your appointments. Your comfort and health, as well as that of your baby, should always be the priority.

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