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Postoperative Visual Loss After Nonocular Surgery: A Case Report.

Fotios Vlahos¹, Vasiliki Kalogianni², Iosifina Giannakikou³

¹From the School of Medicine and Surgery, University of Milano-Bicocca, Milan, Italy.

|July 29, 2025

Summary

A patient experienced sudden vision loss after surgery due to emboli from the carotid artery. This was caused by radiation arteritis, a complication of prior neck radiation therapy, leading to plaque buildup.

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Area of Science:

Ophthalmology
Vascular Surgery
Oncology

Background:

Postoperative vision loss after nonocular surgery can stem from ischemic optic neuropathy or central retinal artery occlusion.
Patients with a history of head and neck cancer treatments, including radiation therapy, may be at increased risk.
Coronary artery disease and oropharyngeal cancer treatments can predispose patients to vascular complications.

Purpose of the Study:

To report a rare case of monocular vision loss following cervical lymph node excision.
To elucidate the underlying cause of vision loss in a patient with a complex medical history.
To highlight radiation arteritis as a potential cause of embolic events leading to vision loss.

Main Methods:

Case report detailing a patient's clinical presentation, medical history, and surgical procedure.
Analysis of the patient's postoperative complications and diagnostic findings.
Review of literature regarding postoperative vision loss and radiation-induced vascular complications.

Main Results:

The patient developed acute, painless, monocular vision loss postoperatively.
Retinal artery occlusion was identified as the cause of vision loss.
The occlusion was attributed to emboli originating from the ipsilateral common carotid artery.

Conclusions:

Radiation arteritis, a consequence of neck radiation therapy, can lead to accelerated atherosclerosis and carotid artery plaque formation.
This plaque can subsequently cause embolic events, resulting in vision loss.
Ophthalmologists and surgeons should consider radiation arteritis in patients with a history of neck radiation presenting with vision loss after nonocular procedures.