Managing Open-angle Glaucoma During Breastfeeding
When a patient with open-angle glaucoma is breastfeeding, intraocular pressure (IOP) management must be adapted to maintain glaucoma control while safeguarding the nursing infant. Both the selection of therapy and the technique of administration become central to clinical decision-making in this setting.
The patient is currently breastfeeding. This modifies the therapeutic approach: glaucoma drop therapy must account for potential infant exposure, and administration technique — including punctal occlusion — plays an important role in reducing systemic absorption.
Maintain IOP control in the target range and prevent glaucoma progression, while minimising risk to the nursing infant.
IOP-lowering therapy is adapted for the breastfeeding context. Punctal occlusion is emphasised as a key administration technique when topical therapy is employed. Medication selection is guided by infant safety considerations, and procedural options may be factored into the plan as an alternative or adjunct to drops.
References
DOI: 10.1016/j.ophtha.2025.12.029
Punctal occlusion should be emphasized when caring for patients who are pregnant or nursing and using glaucoma drop therapy.
The American Academy of Pediatrics has approved the use of both oral and topical forms of carbonic anhydrase inhibitors during lactation, although the infant should be carefully monitored when the former are used.
Laser trabeculoplasty surgery may be considered as an alternative or adjunct to medical therapy in select patients during pregnancy and breastfeeding.
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