• Am. J. Ophthalmol. · Mar 1999

    Case Reports

    Bilateral posterior ischemic optic neuropathy after spinal surgery.

    • G Alexandrakis and B L Lam.
    • Bascom Palmer Eye Institute, University of Miami School of Medicine, Florida 33136, USA.
    • Am. J. Ophthalmol. 1999 Mar 1; 127 (3): 354-5.

    PurposeTo report the association between bilateral posterior ischemic optic neuropathy and spinal surgery.MethodCase report.ResultsAfter prone-position spinal surgery of 8 hours' duration, a 68-year-old woman was completely blind in both eyes. Moderate periorbital edema and temporal conjunctival chemosis were present bilaterally. Ophthalmic examination disclosed normal-appearing optic nerve heads, except for bilateral nasal fullness related to bilateral optic nerve drusen, and no retinal edema. Immediate cerebral arteriography, magnetic resonance imaging, and electroretinography were normal. Visual-evoked response was not detectable, and 7 weeks later, severe bilateral optic nerve head pallor developed.ConclusionsSevere selective hypoperfusion of the retrobulbar optic nerves may occur after spinal surgery. Pressure to the periorbital region may be a contributing factor.

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