Rare Ocular Complication After Prone Position Surgery: Bilateral Subconjunctival Hemorrhage Following Endoscopic...

Subconjunctival hemorrhage (SCH) is a rare complication in spinal surgery and is even more uncommon in endoscopic procedures, which are typically of short duration. We report the case of a 32-year-old male who developed bilateral SCH after an uneventful L4-L5 lumbar endoscopic discectomy performed under general anesthesia. The patient had a history of well-controlled hypertension and was not on anticoagulant therapy. The surgery lasted approximately 50 minutes, with appropriate head protection and smooth airway management. On the first postoperative day, bilateral SCH was observed without pain or visual disturbance. The hemorrhages resolved spontaneously within two weeks without complications. Although the exact mechanism remains unclear, contributing factors may include prone positioning, venous congestion, hemodynamic shifts, and hypertension-related vascular fragility. This case highlights the importance of recognizing subconjunctival hemorrhage as a rare but benign complication of prone spinal surgery, and suggests that patient reassurance and awareness are essential.