Baisse brutale de l'acuité visuelle après chirurgie

Postoperative visual loss emerged recently as a concern for anesthesiologists; risk factors and the need for an early diagnosis and prevention have been highlighted a few years ago. Corneal abrasion is easily preventable. Functional sequelae are important when lesions lay into the visual axis. Ischaemic complications, such as retina central artery occlusion or ischemic optic neuropathy, are mainly due to an increase in intraocular pressure, associated or not to a lower systemic perfusion pressure. Recovery of visual loss is hopeless. Ischaemic cerebral lesions, as part of cardiovascular complications, share the same poor prognosis. Prevention of visual loss after surgery is critical: repeated checking of patient positioning during surgical procedures at risk is mandatory to avoid orbital compression; prevention also includes the maintenance of arterial perfusion pressure and haemoglobin level to maintain oxygen supply, especially in patients with cardiovascular risk.