Release hallucinations and visual loss as first manifestations of postoperative unilateral blindness.
OBJECTIVE
Release hallucinations (RH) with insight into the unreality of the hallucination have been reported in association with severe vision loss. Postoperative blindness following nonocular surgery may appear associated with central retinal artery occlusion (CRAO) caused by incorrect head positioning during surgery, intraoperative hypotension, and atherosclerosis. RH may initially mask the loss of vision.


METHODS
Case report.


RESULTS
A 27-year-old woman who had undergone lumbar spinal surgery for right L4-L5 discal herniation developed left eye visual loss and complex visual hallucinations immediately after surgery. Her symptoms were initially considered hallucinations related to the anesthesia and not taken into consideration until 4 days later. Ophthalmic examination disclosed CRAO probably caused by ocular compression during surgery. Optic nerve atrophy appeared during the following 6 years.


CONCLUSIONS
Doctors and auxiliary personnel should be aware that visual hallucinations may be a sign of actual vision damage.
Montero
J A
JA
Pio del Rio Hortega University Hospital, Ophthalmology Unit, Valladolid, Spain. javmonmor@hotmail.com
Ruiz-Moreno
J M
JM
Galindo
A
A
Fernandez-Muñoz
M
M
D000328:Adult; D020757:Amaurosis Fugax / Q000209:etiology* / Q000503:physiopathology; D017586:Diskectomy / Q000009:adverse effects*; D005260:Female; D006212:Hallucinations / Q000209:etiology* / Q000503:physiopathology; D006801:Humans; D007405:Intervertebral Disc Displacement / Q000601:surgery; D008159:Lumbar Vertebrae; D015356:Retinal Artery Occlusion / Q000150:complications / Q000503:physiopathology; D014792:Visual Acuity