A Case Report on Acute Visual Loss With Ophthalmoplegia Following Spine Surgery

Postoperative vision loss is an unusual but serious side effect that can occur after nonocular surgeries, particularly those involving the heart or spine. Various causes, including ischemic optic neuropathy, central retinal artery occlusion, central retinal vein occlusion, and ischemic orbital compartment syndrome, can cause this condition. Here, we present a case of a 28-year-old male patient who underwent spine surgery for cervicodorsal spine injury and experienced sudden, painless vision loss in his left eye following the surgery. On examination, his right eye had a bedside vision of >3/60, while his left eye could only perceive light. The patient's left eye showed mild axial proptosis, supraorbital edema, conjunctival congestion, chemosis, relative afferent papillary defect, and restricted eye movements in all gazes. Fundus examination of the left eye showed pale retina, optic disc pallor, severely attenuated retinal vessels, and an absent cherry red spot suggesting ophthalmic artery occlusion. The right eye anterior segment and fundus findings were normal. Magnetic resonance imaging of the brain and orbit showed mild preseptal thickening in the left orbit, and magnetic resonance venography was normal. This case report is noteworthy in that an ophthalmic artery occlusion has been identified as the cause of sudden, unilateral, painless vision loss associated with ophthalmoplegia subsequent to a spinal surgical procedure.