Protecting Sight During Cardiac Surgery: Mechanisms, Risks, and Management of Perioperative Ocular Complications

Ophthalmic complications during a major cardiac surgery are rare but may have serious consequences. Patients requiring intraoperative support from a cardiopulmonary bypass machine have an increased risk of developing ocular adverse effects because of significant hemodynamic alterations involving the systemic and ocular vasculature. Ocular conditions experienced by patients undergoing cardiac surgery range from corneal abrasions to retinal artery occlusions or ischemic optic neuropathies. Postoperative vision loss may also occur because of cerebrovascular pathologies, such as stroke, pituitary apoplexy, or even cortical blindness. Here, we review perioperative ophthalmic complications encountered in cardiac surgery patients to guide clinicians in their diagnosis and management.