STUDY ON OCULAR CHANGES IN PRE-ECLAMPSIAAND ECLAMPSIA IN A TERTIARY CARE TEACHING HOSPITAL IN BIHAR

Abstract

Pre-eclampsia and eclampsia are hypertensive disorders of pregnancy which involve multiple organ systems including eye and CNS. Endothelial dysfunction associated with the disease affects retinal vasculature leading to visual disturbance. A prospective, observational study conducted at Patna Medical College Hospital, Patna, Bihar between October 2018 to September 2019. The aim was to assess the ocular changes and associated visual deficit in patients of pre-eclampsia and eclampsia and to evaluate possible residual visual symptoms during the follow-up period of 6 weeks after termination of pregnancy. The study included 200 patients of pre-eclampsia and eclampsia. None of the patients had history of use of glasses, any previous ocular complaints or significant treatment history for ocular problems. Visual disturbance was complained by 43 patients. A thorough ocular evaluation was performed by a trained team of ophthalmologists. Patients were treated according to NICE guideline given for managing gestational hypertension. Repeat fundoscopy was performed after 2 weeks of pregnancy termination. The mean duration between onset of visual symptom to hospital consultation was 7-10 days. Although permanent impairment of vision is rare, emergency providers in rural areas should be taught about visual symptoms arising in pregnancy and for referral services. Obstetricians should be conscious of possible eye changes and should consult ophthalmologist for diagnostic options. Fundoscopy is a simple but effective procedure to detect ocular changes in asymptomatic patients and may help in initiating treatment and preventing complications. Women and families must be stressed upon for regular antenatal care.