Unilateral blindness after prone lumbar spine surgery.

VISUAL loss after nonocular surgery is a rare but devastating perioperative complication. It has been documented in a wide variety of procedures, the most common of which are cardiopulmonary bypass, head and neck operations, and prone spine operations. Ischemic optic neuropathy is the most common diagnosis in these cases. Factors believed to be associated with its occurrence are large intraoperative blood loss, long duration in the prone position, and intraoperative hypotension and anemia. We present a case of unilateral posterior ischemic optic neuropathy occurring after an uneventful prone lumbar spine operation in a relatively healthy man who did not have decreased blood pressure and hematocrit perioperatively.