Pregnancy results in hormonal changes that produce ocular effects. Normal pregnancies and pregnancies associated with underlying systemic pathology are considered here in a review of the recent literature. With current advances made in all areas of prenatal care, the optometrist can become an important link in the chain of primary health care delivery to his or her pregnant patients. This may be achieved by patient management and education or by referral and consultation/co-management with the appropriate specialist(s).