Can Natural Birth Be Safe for Pregnant Women with Corneal Scarring?

Can a person with a scar on the cornea have a natural birth during pregnancy?

Hello, Doctor: I would like to ask about my situation.
I had a laceration of the eyelid from a car accident 12 years ago, and since I did not have the eyelid repaired at that time, it has resulted in incomplete eyelid closure.
Later, I developed corneal disease with scarring and an increase in microvascular growth.
Currently, I have only slight incomplete eyelid closure, and at night, I use artificial tears (or vitamin A ointment) to keep my eyes moist.
Sometimes, I experience increased intraocular pressure, which causes redness and discomfort in my eyes.
I am currently in the late stages of pregnancy, and I am concerned about whether delivering vaginally might pose any risks to my eyes.
Thank you for your understanding and response.
Thank you!

mei jing shen, 30~39 year old female. Ask Date: 2012/12/18

Dr. Wang Yuwei reply Ophthalmology

Based on your description, it appears to be a laceration of the eyelid, with no corneal injury.
The scarring is due to poor eyelid closure, so you can be assured that a natural delivery is safe.
Wishing you and your baby good health and a smooth delivery!

Reply Date: 2012/12/18

More Info

When considering the safety of natural birth for pregnant women with corneal scarring, it is essential to evaluate both the ocular condition and the physiological changes that occur during labor. Corneal scarring, especially when associated with incomplete eyelid closure, can lead to complications such as dryness, irritation, and potential exposure keratopathy. These issues can be exacerbated during labor due to the physical exertion and stress involved in the birthing process.

During natural childbirth, women often experience significant physical strain, including increased intra-abdominal pressure and changes in blood flow. For someone with corneal scarring, this could potentially lead to increased ocular discomfort or exacerbation of existing symptoms, such as redness or irritation. However, the act of giving birth itself does not directly affect the cornea or the eye's structure. The primary concern would be managing any discomfort or complications that arise from the existing ocular condition during labor.

It is crucial to maintain proper eye care leading up to and during labor. Using lubricating eye ointments, such as the ones you mentioned (like artificial tears or vitamin A ointment), can help keep the eyes moist and reduce discomfort. Additionally, it would be wise to discuss your specific situation with both your obstetrician and an ophthalmologist. They can provide tailored advice on managing your eye condition during labor and may suggest strategies to minimize any potential risks.

Moreover, if you experience any significant changes in your vision or increased discomfort as you approach your due date, it is essential to seek medical attention promptly. Your healthcare providers can monitor your condition and ensure that both you and your baby remain healthy throughout the labor process.

In summary, while having corneal scarring may present some challenges during natural childbirth, with proper management and communication with your healthcare team, it is generally safe to proceed with a natural birth. The key is to ensure that your eye condition is well-managed and that you have a plan in place for any potential discomfort during labor. Always prioritize open communication with your healthcare providers to address any concerns you may have as you approach your delivery date.

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