Loss of Vision After Surgery: What's the Cause?

Helene M. Kaiser, OD; Case Series Editor: Jean Marie Pagani, OD

Disclosures

July 08, 2014

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.

Her medical history was significant for stage 3 ovarian cancer and breast cancer 8 months previously, which required surgery. She has had 1 myocardial infarction.

Eye Examination

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)

Figure 1a. Dilated fundus examination; optic nerves OS. 1b. Dilated fundus exam; optic nerves OD.

Figure 2a. Automated visual field testing; superior altitudinal defect OS. 2b. Automated visual field testing; peripheral constriction denser inferiorly OD.

Comments

3090D553-9492-4563-8681-AD288FA52ACE
Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as:

processing....