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Dr. James
Dr. James, Board Certified Ophthalmologist
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In rather pioneering laser surgery in Romania in 1983 (26 years

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In rather pioneering laser surgery in Romania in 1983 (26 years ago), I have been operated of bilateral congenital cataract and have crystalline implants. All is fine: ocular pressure R and L 17, vision R 6/9 and L 6/12, and this surgery means I can lead a successful life.
I am due to give birth next month. I have seen an ophthalmologist in UK who has told me, unsurprisingly, that there is no medical record of cases such as mine and their risks in labour. It was surprising however to be told that despite this lack of knowledge, the standard medical routine would apply during labour in my case (as opposed to more attention being given to me). Moreover, my Romanian doctor has advised me that I can give birth naturally, but that I should have pilocarpine 2% drops in my eyes every 4 hours.
In your opinion, would I need any special monitoring during labour? What would it consist of? Should I have the ocular pressure monitored? Could I self-administer the pilocarpine drops? Thank you.
Submitted: 5 years ago.
Category: Eye
Expert:  Dr. James replied 5 years ago.
HelloCustomer

How old were you when you had surgery for the congenital cataracts? What drops are you currently using? Any history of elevated eye pressure in the past?

Customer: replied 5 years ago.

In reply to your questions:

- I was 5 years old when surgery was performed. I am now 32.

- I have not and am not using any drops. In fact, my eye medical history is really straightforward, and kept in high regards XXXXX XXXXX very successful story. For instance, I am only using reading glasses, and do not need glasses when driving or for distance. I only see an ophthalmologist twice a year for a routine control of my vision and ocular pressure.

- I do not have a history of elevated eye pressure. I keep track of the readings taken during my eye appointments, and the highest has been 19 (only once, in 2006). I can add that my blood pressure is rather low, around 100 / 55. Moreover, my pregnancy has been very easy, without any problems whatsoever.

I will be waiting for your advice.

Expert:  Dr. James replied 5 years ago.
Thank you for the additional information.

There is high incidence of glaucoma after surgery for congenital cataracts. It is unclear exactly why. So, your story is indeed quite a success -- good vision and without glaucoma.

I do not believe you need to take extra precaution during the labor. The exertion during labor will increase the eye pressure, but it is only temporary during those times. An this occurs in everyone. I recommend you get an exam before and after the delivery to make sure that the pressures are still within the normal range.

Bilateral congenital cataracts tend to be more hereditary in nature. Make sure you alert your pediatrician/neonatologist of this history in case they want to do any extra testing.

Remember to press the green accept button. It was a pleasure helping you with your question. Feel free to ask any addtional questions. Smile


Dr. James, Board Certified Ophthalmologist
Category: Eye
Satisfied Customers: 2282
Experience: Eye Physician and Surgeon
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