Ischemic optic neuropathy after spine surgery

Visual loss is a traumatic occurrence that has been reported after prone spine surgical procedures performed under general anesthesia. The most common cause of postoperative visual loss is ischemic optic neuropathy. Although the incidence of postoperative visual loss is rare, this devastating injury has been reported more frequently. Several factors increase the risk for the development of ischemic optic neuropathy. Results from several case studies have attributed ischemic optic neuropathy with vision loss after general anesthesia to perioperative anemia, blood loss, hypotension, and prolonged operative times. Ischemic optic neuropathy usually presents with painless visual loss and visual field deficits during the immediate postoperative period. There is no definitive treatment. Prevention is the key.