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Perioperative posterior ischemic optic neuropathy could lead to visual loss after blepharoplasty
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A secondary cause of optic nerve damage in patients with blepharoplasty may be perioperative posterior ischemic optic neuropathy leading to visual loss, according to a case study. Optic nerve damage may include compromised small arteries perfusing the optic disc because of a direct mechanical compression and a probable vasoconstrictive activity of the anesthetic agent, the study authors said.
H. Kordic and colleagues at the University of Basel in Switzerland described the case of a 46-year-old man who had undergone combined bilateral upper and lower lid blepharoplasty 3 days earlier. Visual acuity in his right eye was light perception only. Fundus exam, fluorescein angiography and magnetic resonance imaging of the orbit were all normal. Ocular motility was full in all directions of gaze.
The perioperative posterior ischemic optic neuropathy diagnosis was based on the Goldmann visual field exam and the subsequent optic atrophy. Central visual acuity, color vision and visual field all improved within 3 months.
The study is published in the May/June issue of Ophthalmologica.