Vision loss after spine surgery: review of the literature and recommendations

i) Study design: Narrative literature review
ii) Postoperative vision loss (POVL) is a rare but devastating complication of spinal surgery, most often due to posterior ischemic optic neuropathy (PION), with reported incidence ranging from 0.028% to 0.2% in spinal procedures.
iii) Key perioperative risk factors include prolonged operative time (>6 hours), significant blood loss (>1 L), and large-volume crystalloid infusion, with patient positioning and overhydration contributing to orbital edema and ischemia.

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