Case Presentation: A Postoperative Complication
A 75-year-old white woman who had undergone surgical oophorectomy 8 days earlier suddenly experienced impairment of vision, which started in the right eye (OD), lasted 4 days, and then affected both eyes (OU).
In the postoperative period, she experienced a hypotensive crisis (blood pressure approximately 80/50 mm Hg) that lasted for 2 days. She also developed severe edema of the lower extremities 4 days postoperatively, which resolved with diuretic treatment.
The following were noted on eye examination:
Best corrected visual acuity: OD 20/30; left eye (OS) 20/40
Pupils equal, round, and reactive to light; no afferent pupillary defect
Extraocular movements: intact
Goldman applanation tonometer: 10 mm Hg OU
Slit-lamp examination: unremarkable except for mild nuclear/cortical lens changes
Maculae and peripheral retinae: clear OU
Dilated fundus examination: see Figure 1
Automated visual field testing: peripheral constriction denser inferiorly OD; superior altitudinal defect in the OS (Figure 2)
Medscape Optometry © 2014
Cite this: Loss of Vision After Surgery: What's the Cause? - Medscape - Jul 08, 2014.