Use of the Proneview Helmet System with a modified table platform for open access to the eyes during prone spine surgery.

Permanent, perioperative visual loss (POVL) is a rare but devastating complication of surgery. The majority of reported POVL cases are associated with spine surgery conducted in the prone position (67%) (1). POVL appeared to be related to a change in a patient’s retinal and/or optic nerve perfusion (1–3). Our goal was to provide a clinically practical method for measuring intraocular pressure, ocular perfusion pressure, and ocular perfusion (using digital retinal vessel/optic disk imaging), so that clinicians may be guided in preventing POVL. Limited access to a prone surgical patient’s eyes makes it challenging to obtain safe, physiologic ocular measurements.