POSTSURGICAL BLINDNESS: Posterior Ischemic Optic Neuropathy (PION) Medical Malpractice

by Chris Kuhlman on March 8, 2016

Posterior ischemic optic neuropathy, or PION, occurs when the back region of the optic nerve leading to one or (usually) both eyes dies. There are multiple times of PION, but potentially the most disturbing occurs following general anesthesia for surgery.  In postsurgical ischemic optic neuropathy, a patient wakes up from surgery moderately to severely blind, or suddenly loses vision within a few days, even if the surgery had nothing to do with the eyes or visual cortex.  It is often accompanied by facial swelling.

Postsurgical PION is also called perioperative, surgical, or shock-induced PION.  No matter what it’s called, it can be caused by multiple factors, but the commonality among cases involving various factors is optic nerve hypoxia.  Hypoxia is the condition in which tissues lack enough oxygen, although not necessarily harmfully so.  People with cardiovascular conditions (such as diabetes, high blood pressure, high cholesterol, a history of smoking, or obesity) are predisposed to hypoxic risks from surgery.

The risk for surgery-related posterior ischemic optic neuropathy increases when blood pressure is lower, pressure in tissue is higher (impeding free blood flow throughout the body or in one area in particular), and the blood can carry less oxygen.

The first factor comes into play if the patient has lost a lot of blood, or importantly, when a patient’s blood vessels dilate under general anesthesia.  Tissue pressure around the optic nerve increases, simply because of gravity, when a patient lies on his or her stomach for an extended period of time without moving, as in spinal surgery.  And blood oxygen levels decrease if the patient loses blood or if his or her blood is diluted with IV solutions during surgery.  Surgeons and anesthesiologists should work together and make sure the sensitive cells of the optic nerve are not cut off from their oxygen supply during surgeries of longer than four hours.

Advocates for those blinded after surgery due to medical negligence

If you or a loved one have suffered blindness after surgery, contact the medical malpractice attorneys at Kuhlman Law, PLLC for a Free Initial Consultation.  We stand up for victims of medical negligence and handle medical malpractice cases on a contingency fee basis.  Call today for a free consultation at (612) 349-2747. 

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