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Postoperative Visual Loss Prone — FRCA Final MCQ

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HardNeuroanaesthesiaPostoperative Visual Loss ProneFRCA Final

A patient undergoing spinal surgery in the prone position has sudden bilateral blindness postoperatively. MRI shows ischaemic optic neuropathy. What is the most likely contributing factor?

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Correct answer: A — Prolonged prone position with raised intraocular pressure

Postoperative visual loss (POVL) after prone spine surgery: ischaemic optic neuropathy is the most common cause. Contributing factors: prolonged prone position, raised IOP (from dependent head position), hypotension, anaemia, prolonged surgery (>6 hours). Wilson frame preferred over chest rolls. Avoid direct globe pressure.

Reference: ASA – 2022 – Practice advisory for perioperative visual loss