Acute visual loss after spinal surgery.
OBJECTIVE
To report visual loss after prone spinal surgery.


METHODS
Computed tomography scan, fundus photography, optical coherence tomography (OCT).


RESULTS
A 56-year-old man demonstrated loss of vision in the left eye after cervical spinal surgery. Clinical examination revealed loss of vision to finger counting, severe visual field defect and blurred neural rim area around the optic disc in the left eye. Six weeks later, visual acuity in the left eye was 6/9 and there was inferior visual field defect. Six months after the surgery, significant reduction of retinal nerve fibre layer thickness around the optic nerve head was measured with OCT, consistent with the visual field defect.


CONCLUSIONS
Ischemic optic neuropathy is the most common cause of visual loss after spine surgery and special emphasis should be given to protect the eye against possible pressure during the surgery.
Department of Neurology, Haukeland University Hospital, Bergen, Norway.
Jana Midelfart
JM
Hoff
Pål
P
Varhaug
Anna
A
Midelfart
Morten
M
Lund-Johansen
D000208:Acute Disease; D001766:Blindness / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D002574:Cervical Vertebrae / Q000000981:diagnostic imaging / Q000293:injuries / Q000601:surgery*; D006801:Humans; D004204:Joint Dislocations / Q000150:complications; D008297:Male; D008875:Middle Aged; D009412:Nerve Fibers / Q000473:pathology; D018917:Optic Neuropathy, Ischemic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D011183:Postoperative Complications; D016684:Prone Position; D011859:Radiography; D012165:Retinal Ganglion Cells / Q000473:pathology; D016103:Spinal Fractures / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery*; D041623:Tomography, Optical Coherence; D014792:Visual Acuity / Q000502:physiology; D014794:Visual Fields / Q000502:physiology