optic nerve damage/blindness

[JCOL116]

can lack of oxygen during surgery cause optic nerve damage and the patient wakes up blind, was having bilateral total knee replacement, age 56 non smoker male with heart diease, high blood pressure.

[loccast]

Head a grade 1 tumor removed four weeks ago. I now have prosopagnosia (face blindness). I cannot recognize faces, not even my own. Neurologist and Neuro Opthamologist have said to give it time. It could take months for brain swelling to decrease and brain circuits to reconnect. Waiting is frustrating. Anyone out there with a similar experience?

[Sandra M Brown, MD]

Prolonged general anesthesia can, extremely rarely, lead to a condition called anterior ischemic optic neuropathy; this often affects both eyes.  It is most often seen in patients having long spine surgeries when they are face down.  It occurs even when the patient is never unstable or lacking oxygen during surgery.  The small blood vessels that supply the optic nerves clot off.  We have no idea why this happens in some patients, no way to predict it, and no way to prevent it.

In the case you describe, if the problem was truly "lack of oxygen", meaning lack of oxygen in the bloodstream, I would expect many other problems in addition to the blindness.  Thus the condition may be anterior ischemic optic neuropathy.