Unilateral blindness after posterior cervical spinal surgery: A case report

The purpose of this study is to report the case of a patient who developed an unusual combination of central retinal artery occlusion with ophthalmoplegia after spinal surgery. A 69-year-old man underwent a cervical spinal fusion surgery in the prone position. He could not open his right eye in the recovery room due to ocular swelling. Upon ophthalmological examination, we determined that he had a central retinal artery occlusion with total ophthalmoplegia. Despite medical treatment, optic atrophy was present at the follow-up examinations. Ptosis and the afferent pupillary defect disappeared, and ocular motility was recovered, but visual loss persisted until the last follow-up. A prolonged prone position during spinal surgery can cause external compression of the eye. This can cause serious and irreversible injury to the orbital structures. Therefore, if the patient shows postoperative signs of orbital swelling after spinal surgery, the condition should be immediately evaluated and treated.