Chiasmal visual loss after retinal detachment.

A 52-year-old man developed severe vision loss in the right eye due to a large retinal detachment. Vitrectomy was performed in that eye, with 15% C3F8 perfluoropropane gas injected into the posterior chamber.1 He transiently regained hand-motion acuity. Posterior chamber paracentesis was performed for elevated intraocular pressure; endophthalmitis was treated with intraocular antibiotics. After 1 week, blurred vision occurred in the left eye, with intact central acuity and a temporal field deficit (figure). CT imaging demonstrated migration of intraocular gas into the optic nerve and chiasm. Chiasmal visual loss is a rare complication of pneumatic retinopexy. Sashank Prasad, MD, and Alexandra Golby, MD, Boston, MA