• Amy Du, Ramsey Saba, Ethan Y Brovman, Penny Greenberg, and Richard D Urman.
• Brigham and Women's Hospital, Boston, MA.
• J Healthc Risk Manag. 2020 Feb 1; 39 (3): 20-27.

IntroductionPerioperative vision loss (POVL) is a rare but catastrophic event. Closed claim databases are useful for investigating risk factors of POVL to help guide practices in risk mitigation and risk management strategies.MethodsWe retrospectively analyzed the Controlled Risk Insurance Company (CRICO) Comparative Benchmarking System database for perioperative nerve injuries from when claims were closed between 2007 and 2016. We then extracted, deidentified, and analyzed all the POVL cases.ResultsOf 53 nerve injury claims closed between 2007 and 2016, we found 9 pertaining to POVL. Of these 9 cases, 100% resulted in permanent injury, 76% were associated with spine surgery, 89% of the patients were positioned prone intraoperatively, 67% were noted to have improper or missing documentation, and 56% of the patients claimed they were not informed of the risk of vision loss during preoperative consenting. Four of the 9 cases were settled, with a mean settlement amount of $906,250 (standard deviation, ± $745,647).ConclusionsPOVL often results in permanent injury with costly burden on the health care system. Risk reduction strategies need to be instituted on the provider and system level, involving a multidisciplinary health care team to develop and execute clinical protocols and patient communication strategies that will help prevent POVL.© 2019 American Society for Healthcare Risk Management of the American Hospital Association.

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