Complications: postoperative visual loss: practice question

A Anaesthesia question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Anaesthesia · Complications: postoperative visual loss

Sample item

A patient wakes with painless bilateral visual loss after a 9-hour prone spine fusion with major blood loss and hypotension. What is the most likely diagnosis?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

D. Ischaemic optic neuropathy

Ischaemic optic neuropathy is the commonest cause of permanent postoperative visual loss after prolonged prone spine surgery. Risk factors include long duration, large blood loss, hypotension, anaemia and large volume resuscitation. Corneal abrasion causes pain rather than painless loss of vision.

Option by option

  • A. Corneal abrasion

    Corneal abrasion produces pain, tearing and photophobia and is not painless visual loss.

  • B. Cortical blindness due to air embolism

    Air embolism would produce other cardiovascular and neurological signs.

  • C. Vitreous haemorrhage from the operation

    Vitreous haemorrhage is not a typical complication of spine surgery.

  • D. Ischaemic optic neuropathy (correct)

    Correct. This setting and painless visual loss fit ischaemic optic neuropathy.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Anaesthesia question

What is the answer to this Anaesthesia question?

The best answer is D, Ischaemic optic neuropathy. Ischaemic optic neuropathy is the commonest cause of permanent postoperative visual loss after prolonged prone spine surgery.

Why is "Corneal abrasion" not the answer?

Corneal abrasion produces pain, tearing and photophobia and is not painless visual loss.

Why is "Cortical blindness due to air embolism" not the answer?

Air embolism would produce other cardiovascular and neurological signs.

Why is "Vitreous haemorrhage from the operation" not the answer?

Vitreous haemorrhage is not a typical complication of spine surgery.

What concept does this question test?

It tests Complications: postoperative visual loss in Anaesthesia. Risk factors include long duration, large blood loss, hypotension, anaemia and large volume resuscitation. Corneal abrasion causes pain rather than painless loss of vision.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Complications: postoperative visual loss?

Make a table of each agent, its key advantage and its main side effect. Then use the flashcards and the other Anaesthesia questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.