Abstract

Postoperative visual loss (POVL) is a rare but serious complication that can occur after non-ocular surgery, with a limited number of documented cases in arthroscopic procedures. The main causes of POVL are central retinal artery occlusion (CRAO), ischemic optic neuropathy (ION) and cerebral vision loss with multiple risk factors. This case report highlights a patient who developed POVL after arthroscopic shoulder surgery, shedding light on possible mechanisms and contributing factors. A 52-year-old man with chronic shoulder pain underwent arthroscopic shoulder surgery. The patient had mild hypertension, a smoking history and slightly elevated lipid levels. After surgery, he developed a sudden loss of vision in his right eye, which led to extensive evaluation. Various tests ruled out stroke, heart problems and other causes. The patient was discharged with eye medication and his vision improved significantly within two weeks. POVL after non-ocular surgery is an important but poorly understood complication. Common causes include ION, CRAO, and others. The incidence is higher with spinal surgery, and anesthesia and positioning increase the risk. This case emphasizes the importance of vigilance and prevention. In this case, the most likely cause was non-arterial CRAO, possibly due to embolism, given the patient's risk factors. The exact position of the patient probably did not play a role. An interscalene block (ISB) was used, but the risk of POVL associated with ISB was low. Although POVL is rare in arthroscopic surgery, careful consideration of various factors, including patient risk factors, surgical techniques, and positioning is critical to prevent this devastating complication. Ensuring accurate ISB injection, regular head and neck checks, and adequate eye padding can minimize the risk. Evaluation of other possible causes, such as CRAO and ION, should lead to the necessary tests and interventions to reduce progression and future risks.