Complications oculaires en chirurgie non ophtalmologique

Perioperative eyes injuries are relatively uncommon after non-ocular surgery. Corneal abrasion is the most frequently reported complication, prevented by eyelids occlusion. Vision loss is a rare but devastating complication primarily associated with cardiac and spine surgery. The causes of vision loss include retinal vascular occlusion, ischemic optic neuropathy and cortical blindness. Detecting high-risk patients, using a head fixator to provide completely direct compression-free positioning of the face and eyes, and a less head-down position, optimizing hemodynamic status and hemoglobin levels should be considered to reduce the risk of perioperative visual loss. Emergent ophthalmological consultation is required to determine the diagnosis. Clinicians need to be attuned to the possibility of less common causes such as acute angle closure glaucoma, expansion of an intraocular vitrectomy bubble by administration of nitrous oxide, posterior reversible encephalopathy syndrome, and glycine toxicity.