Ischemia of ciliary arterial circulation from ocular compression
L. M. Jampol, M. Goldbaum, M. Rosenberg and R. Bahr
Two patients developed unilateral central retinal artery and posterior
ciliary artery occlusions related to ocular compression during general
anesthesia. One patient had evidence of extensive choroidal ischemia with
diffuse hypopigmentation, pigmentary mottling of the posterior pole, and
disc edema. Electroretinography showed diminution of the A and B waves. The
other patient showed patchy choroidal ischemia with subsequent development
of wedge-shaped areas of pigmentary atrophy and mottling in the
midperiphery. Iridocyclitis and prolonged hypotony were also present.
Retinal and posterior ciliary artery occlusion (perhaps at the level of the
ophthalmic artery) can occur as a result of ocular compression by a face
mask or an improperly positioned headrest. Systemic hypotension is a factor
in many cases. Proper positioning of the head on an adequate headrest and
avoidance of ocular compression will prevent the occurrence of retinal and
choroidal occlusion during general anesthesia.
