Perioperative Visual Loss Associated with Spine Surgery

Review a patient’s preoperative history and perform an appropriate examination to identify patients with conditions such as preoperative anemia, vascular risk factors (e.g., hypertension, diabetes, peripheral vascular disease, coronary artery disease, previous stroke, carotid artery stenosis, tobacco use), and obesity.

Inform patients that certain preoperative conditions may increase their risk of perioperative visual loss in spine surgery. These include, but are not limited to, those who are male, obese, or have vascular disease risk factors such as hypertension, and peripheral vascular disease.

Inform patients in whom prolonged procedures, substantial blood loss, or both are anticipated that there may be an increased risk of perioperative visual loss.

• Determine on a case-by-case basis whether or not to inform patients who are not anticipated to be “high-risk” for visual loss.