USE OF EYE DROPS IN PREGNANCY

Eye drops are used to administer medication to the eye and, depending on the condition being treated, may contain steroids, antibiotics, antihistamines, sympathomimetics, prostaglandins, beta-blockers, parasympathomimetics, parasympatholytics, non-steroidal anti-inflammatory drugs (NSAIDs) or topical anaesthetics.

There are few published data on the potential fetotoxic effects of topical ophthalmic medications in human pregnancy. Pharmacokinetic data on the systemic absorption of individual preparations are also lacking. However, many of the drugs found in eye drops are administered systemically in pregnancy without conclusive evidence of an increased risk of congenital malformation or other adverse pregnancy outcome in the offspring. Although it is therefore unlikely that ocular administration of such drugs will be associated with an increased risk of fetal toxicity if the dose used does not exceed that of systemic regimes, medications which have known fetal effects following systemic use should be used with caution as some systemic absorption of ocular preparations is possible. Where ocular use of a potentially teratogenic preparation is considered necessary in pregnancy, discussion with the patient should include both the risks of not treating the condition as well as any known or theoretical risks to the fetus.

Exposure to topical ophthalmic medications at any stage in pregnancy would not usually be regarded as medical grounds for termination of pregnancy. The need for additional fetal monitoring should be assessed based on the specific medication. Other risk factors which independently increase the risk of adverse pregnancy outcome may also be present in individual cases. Clinicians are reminded of the importance of consideration of such factors when performing case-specific risk assessments.

Please refer to the UKTIS monograph for each specific medication where available.