Neuroophthalmological complications of ocular surgery

Visual dysfunction, including visual loss and diplopia, may occur in association with ocular surgery. Strabismus may be the most common abnormal eye movement seen as a complication of local anesthesia. Local anesthesia also may cause direct and indirect traumatic optic neuropathy. Vitrectomy is associated with visual-field loss from direct manipulation of the nerve fiber layer during suctioning of the vitreous or by direct compression of intraocular gas. Trabeculectomy may be complicated by visual-field loss. Patients may be at higher risk if their eye is hypotonous after surgery, but the duration or severity of hypotony that places the eye at risk is unknown. The only neuroophthalmic complication directly related to cataract surgery itself is AION. Complications of ONSD include motility disorders, pupillary dysfunction, and vascular compromise. Neuroophthalmic complications are uncommon after blepharoplasty. They include ocular motility disorders, transient pupil dilation, and vision loss.