Postoperative visual loss (POVL) is a complication that may cause vision loss or total blindness after major surgical procedures such as spine surgery. Postoperative visual loss is probably multifactorial, however, patients with a large amount of blood loss producing hypotension and anemia along with prolonged operative times have greater risk of developing visual disturbances. POVL is not only severe, but it occurs frequently enough that lawyers should be familiar with it.
In recent studies spinal surgery has replaced cardiac surgery as a leading cause of postoperative vision loss. Estimates of the incidence of POVL after spinal surgery range from 0.028 to 0.2%, but with advances in complex spinal instrumentation and the rise in annual spinal operations, POVL may see an increase in its incidence. See Journal of Neurosurgery.
Many factors interact to cause PVOL, but the most important involve the body's ability to carry and deliver oxygen to tissues in the optic nerve. Often, POVL occurs when anesthesiologists fail to maintain blood pressure and blood status during a long surgical procedure, such as spinal surgery. When a patient loses a large amount of blood during a surgical procedure, non-blood fluids are used to maintain the patient's blood pressure. When low arterial blood pressure, diluted blood, and increased venous and tissue pressures are maintained for a long time, the body cannot deliver sufficient amounts of oxygen to the optic nerve and may cause permanent visual loss.
Physicians may be held liable for POVL if their treatment falls below the standard of care. Although the risk of POVL cannot be eliminated, the risks of POVL is greatly reduced in surgeries that last less than six hours and involve less than a liter of blood loss. What's more, physicians have a duty to inform the patient that visual loss is a risk prior to undergoing surgery. A physician may be held liable for damages caused if they fail to obtain a patients informed consent.
If you have suffered POVL as a result of a surgical procedure, call me for a free no obligation consultation. 267-443-8487
