What are the common causes of halos in obstetrics (OB) and gynecology (GYN)?

From the Guidelines

Halos in obstetrics and gynecology are most commonly caused by elevated intraocular pressure associated with pregnancy-induced hypertension or preeclampsia, and patients reporting persistent halos should be promptly evaluated for these conditions. The visual disturbances occur when fluid accumulates in the cornea, causing light to scatter as it enters the eye 1. Other common causes include medication side effects, particularly from topical eye medications containing beta-blockers or prostaglandin analogs that may be used during pregnancy for glaucoma management. Physiological changes during pregnancy, such as increased fluid retention and hormonal fluctuations, can also contribute to temporary corneal edema resulting in halos. Additionally, migraine with aura, which is more common in women of reproductive age, can produce visual disturbances including halos. In gynecological contexts, halos may be reported as side effects of hormonal therapies or may indicate ocular complications of conditions like polycystic ovary syndrome.

Some key points to consider when evaluating halos in obstetrics and gynecology include:

• The importance of promptly evaluating patients for preeclampsia if pregnant, given the potential for severe complications if left untreated 1
• The role of medication side effects, particularly from topical eye medications, in contributing to halos
• The potential for physiological changes during pregnancy to cause temporary corneal edema and halos
• The need to consider migraine with aura and other neurological conditions as potential causes of halos
• The importance of referring patients to ophthalmology for assessment of potential glaucoma or other ocular conditions, regardless of pregnancy status.

It's worth noting that while the provided evidence includes information on nonimmune hydrops fetalis and the use of imaging in large vessel vasculitis, these topics are not directly relevant to the question of common causes of halos in obstetrics and gynecology 1. Therefore, the focus should remain on the most common and relevant causes of halos in this context, which are primarily related to pregnancy-induced hypertension, preeclampsia, and other obstetric and gynecological conditions.

From the Research

Common Causes of Halos in Obstetrics and Gynecology

• Halos around lights can be a symptom of various conditions, including those related to obstetrics and gynecology (OB/GYN) 2
• In the context of OB/GYN, halos can be associated with:
  • Preeclampsia and eclampsia, which can cause visual disturbances, including halos around lights 3, 4
  • Cytomegalovirus (CMV) infection in fetuses, which can cause a periventricular echogenic halo sign on ultrasound 5
• Other conditions that may cause halos include:
  • Drug-induced acute angle-closure glaucoma, which can cause halos around lights due to elevated intraocular pressure 2
  • Intestinal lymphangiectasia, which can cause a CT halo sign 6
• It is essential to note that these conditions may have different underlying mechanisms and treatment strategies, and a proper diagnosis is necessary to determine the cause of halos in individual cases 2, 5, 3, 4, 6