title: Visual loss following head and neck surgery.
abstract: BACKGROUND
  Non-arteritic ischaemic optic neuritis is a known post-operative complication of ophthalmological and maxillofacial surgery, but has not been widely described as a potential consequence of head and neck surgery.
  
  
  OBJECTIVE
  To highlight non-arteritic ischaemic optic neuritis as a potential risk in patients undergoing head and neck surgery.
  
  
  METHODS
  Case report of a 60-year-old man undergoing total laryngectomy and bilateral neck dissection for laryngeal squamous cell carcinoma.
  
  
  RESULTS
  On day 14 post-operatively, the patient suffered substantial oral bleeding secondary to an internal jugulo-neopharyngeal fistula. Following emergency haemostatic measures, the patient was immediately aware of visual disturbances. The ophthalmologists concluded that these were due to non-arteritic ischaemic optic neuritis, caused by acute hypoxaemia secondary to substantial blood loss.
  
  
  CONCLUSIONS
  The prognosis of non-arteritic ischaemic optic neuritis is poor. Thus, it is crucial that otolaryngologists are aware of this complication of head and neck surgery, as immediate diagnosis and treatment can help prevent worsening visual loss.
authors: Department of ENT, Luton and Dunstable Hospital, Luton, UK.
authors: A J B
authors: AJ
authors: Crockett
authors: A
authors: A
authors: Trinidade
authors: P
authors: P
authors: Kothari
authors: J
authors: J
authors: Barnes
mesh_terms: D001766:Blindness / Q000209:etiology*; D002294:Carcinoma, Squamous Cell / Q000601:surgery; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D007511:Ischemia; D007601:Jugular Veins / Q000293:injuries / Q000601:surgery; D007822:Laryngeal Neoplasms / Q000601:surgery; D007825:Laryngectomy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000009:adverse effects*; D009900:Optic Nerve / Q000098:blood supply; D009902:Optic Neuritis / Q000209:etiology*; D019106:Postoperative Hemorrhage / Q000150:complications* / Q000601:surgery