Advisory for Preoperative Patient Evaluation and Preparation.
Although the consultants and specialty society members
agree that there are identifiable preoperative risk factors,
at this time the Task Force does not believe that there are
identifiable preoperative patient characteristics that predispose
patients to perioperative ION. In addition, the Task
Force believes that there is no evidence that an ophthalmic or
neuro-ophthalmic evaluation would be useful in identifying
patients at risk for perioperative visual loss. The Task Force
believes that the risk of perioperative ION may be increased
in patients who undergo prolonged procedures, have substantial
blood loss, or both. Consider informing patients in
whom prolonged procedures, substantial blood loss, or both
are anticipated that there is a small, unpredictable risk of
perioperative visual loss. Because the frequency of visual loss
after spine surgery of short duration is very low, the decision
to inform patients who are not anticipated to be “high risk”
for visual loss should be determined on a case-by-case basis.