Corneal abrasion is the most common ocular complication after general anesthesia

Ischemic Optic neuropathy (ION) and Central Retinal Artery Occlusion (CRAO) are the commonest causes for postoperative visual loss

ISCHEMIC OPTIC NEUROPATHY (ION)

More common among the two

Most often seen after prolonged surgery in prone position

Venous congestion–> Raised Intra Ocular Pressure (IOP) due to Raised Intra Orbital Pressure –> Intra Orbital ‘Compartment Syndrome’

Hypotension, Diabetes, Vascular disease, Smoking etc also may be important in the etiopathogenesis

Treatment:

Reduce optic nerve edema as it passes through posterior scleral foramen with steroids and mannitol

Optimal oxygen delivery by ensuring normal blood pressure and hematocrit

Clear all obstruction to venous drainage

Chance of visual recovery is less

CENTRAL RETINAL ARTERY OCCLUSION (CRAO)

External pressure on eye and embolism are risk factors

An echocardiogram and carotid ultrasound may help us to find an embolic source

Reference: White E, David DB. Care of the eye during anaesthesia and intensive care. Anaesth Intens Care Med. 2007; 8(9): 383–386.