Post-Operative Vision Loss (POVL)

Updated February 22, 2014
Author: APSF

Description: Resource page for POVL: what we know, decreasing the risk, and informing the patient


Introduction:

POVL is assumed to be due to

 

High-risk patients for ION are defined as


Risk Factors


Interventions that may reduce the likelihood of POVL caused by ION


Informed Consent

During the informed consent process, anesthesia professionals and surgeons should include discussion of the remote risk (<1%) of visual impairment, ranging from partial vision loss to complete blindness in both eyes for patients considered to be at risk for POVL from ION.

The informed consent process may include a discussion of risk factors (see above)
and the current understanding of interventions that may reduce the likelihood of POVL caused by ION (see above)

Discussion may include the concept that this complication is difficult to study because of its low incidence. Preventive measures are based on the our best educated guess from what we know of the risk factors but have not been tested.

The APSF suggests that it is the Surgeon's Primary Responsibility to inform the patient of this remote but catastrophic complication. On the day of surgery, the Anesthesiologist should confirm that this discussion between the Surgeon and the Patient has occured. If the Surgeon has not done this, then the Anesthesiologist must include a full discussion in the Informed Consent.


Summary

POVL Video (2014) from Anesthesia Patient Safety Foundation (10 minutes): Focuses on Informed Consent

 

 


References

APSF Multi-Disciplinary Conference on PONV 2013 Summary (pdf)

ASA Practice Advisory on POVL: Anesthesiology 2012;116:274-282