Should a very near-sighted person be delivered by cesarean to prevent retinal detachment?
Modern ophthalmology and obstetric research consistently shows that severe myopia (near-sightedness) is not an indication for cesarean delivery.
Labor, pushing, and Valsalva do not increase the risk of:
- retinal tears
- retinal detachment
- worsening high myopia
The American Academy of Ophthalmology (AAO), UK Royal College of Ophthalmologists, and international obstetric guidelines agree that vaginal delivery is safe for almost all women with myopia, including high myopia (greater than −6.00 diopters).
When is ophthalmology consultation appropriate?
- Active retinal detachment
- Symptomatic retinal tears or lattice degeneration
- Very recent retinal surgery (e.g., vitrectomy)
- Progressive retinal disease
Even in women with a history of retinal detachment who have undergone successful repair, vaginal delivery is typically allowed. Cesarean delivery is rarely required and should be based on standard obstetric indications, not myopia alone.
Bottom line:
Severe near-sightedness by itself is not a medical reason for cesarean delivery.
References
1. Sobczyk K et al. High myopia and childbirth: is cesarean section necessary? Acta Obstet Gynecol Scand. 2012.
2. American Academy of Ophthalmology (AAO). Preferred Practice Patterns: High Myopia and Vitreoretinal Disease. Updated 2023.
3. Royal College of Ophthalmologists (RCOphth). Pregnancy and Eye Disease Guideline. 2022.
4. Prost M. Severe myopia and delivery. Klin Oczna. 1996;98(2):129-30.
5. Katsulov A et al. Myopia and labor. Akush Ginekol (Sofiia). 1999;38(3):51-4.
6. Kuba GB et al. Eye disease and mode of delivery. Klin Monatsbl Augenheilkd. 1997;211(6):349-53.