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Pregnancy and keratoconus: what you need to know

Eye Practice
Pregnancy and keratoconus: what you need to know

Studies have shown that pregnancy hormones can trigger progression of your keratoconus eye disease. But what does this really mean and what can you do to protect your eyesight?


Pregnancy hormones affect different women differently. Some sail through, barely altered apart from a tummy bump. Others suffer with morning sickness, varicose veins or develop gestational diabetes. When it comes to keratoconus, your pregnancy may have no impact on your disease. Or, if you have underlying undiagnosed keratoconus, it could suddenly become noticeable. If you already have the eye disease and are stable, it could become a bit worse.


Are hormones the culprit?


The exact causes of keratoconus are not fully understood. What is known is that it is multifactorial – meaning a combination of factors are involved.  The disease is most often diagnosed during or following puberty. It can advance rapidly during these years. Allergy also plays a role. Vigorous eye-rubbing, especially with the knuckles, is believed to weaken the cornea and cause worsening of the disease.


Can pregnancy cause keratoconus?


Pregnancy is very unlikely to be linked to keratoconus in someone with a perfectly healthy cornea.  There are many people who have a mild, subclinical form of the disease, called forme fruste keratoconus. It doesn’t have symptoms even though the cornea is not normal.  A study of pregnant women with keratoconus was the first solid evidence that pregnancy could cause progression of keratoconus.   

The study concluded that the hormonal changes of pregnancy could have a detrimental effect on the structure of the cornea. Pregnancy was therefore a risk factor for worsening of keratoconus. 1 

There have also been instances of women being diagnosed with keratoconus after pregnancy. 2. But this is more likely to occur if you already have abnormal corneas to begin with.

What can I do?

If you have keratoconus, or a family history of the disease, it is important to be aware that pregnancy can cause it to worsen. Studies show an average change of about 1.5 dioptres, which, in the scheme of things, is not the end of the world. What is important to know is that the fit of your contact lenses may need to be changed to accommodate the new shape of your eye and ensure there is no rubbing of the lens on the delicate centre of your cornea.


Things to do during pregnancy if you have keratoconus or a family history of it


  • If you have a sibling with the disease, see your keratoconus specialist for baseline measurements of the shape of your cornea. This will allow any changes to be followed during your pregnancy
  • If you already have keratoconus and are wearing hard contact lenses, see your contact lens practitioner every 3 months to track any changes in the shape of your corneas. You may need a new pair of contact if the current ones are starting to rub on the centre of your cornea. Contact lenses that touch or rub on the centre of your cornea can quickly lead to corneal scarring or perforation and this is a fast track to a corneal transplant.
  • Even if you keratoconus is stable and you don’t wear contact lenses, it’s a good idea to have your eyes checked to make sure there is no deterioration.
  • If you suffer from allergies such as hay fever, talk to your obstetrician about what you can safely take to manage the allergy. Itchy eyes lead to eye rubbing and eye rubbing leads to worsening of this eye disease.
  • If your eyes are itchy, don’t rub! Try cold compresses to relieve the itch. Using a gel cool-pack from the fridge for a relaxing way to cool off your eyes.
  • Thyroid dysfunction has also been shown to be associated with worsening of keratoconus during pregnancy, so make sure your thyroid hormones are checked by your doctor.


Don’t worry too much about your eyes! Becoming pregnant and bringing a child into the world are much more important than small changes to the shape of your cornea. With the appropriate care from your keratoconus specialist and an adjustment in contact lens fit – if needed – you can spend your time thinking about more exciting things - like baby names!


Pregnant and suffering from keratoconus? Put your mind at ease. Call The Eye Practice on (02) 9290 1899 or make an appointment online today. 

1. Bilgihan K et al. Pregnancy-induced progression of keratoconus.  Cornea. 2011 Sep;30(9):991-4
2. Gliceria J et al. Pregnancy-induced progression of keratoconus in a 37-year-old patient.  Int J Kerat Ect Cor Dis. 2011 Sep;30(9):991-4
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