Acute visual loss after spinal surgery

Purpose: 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. Conclusion: 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.