Delayed anterior ischemic optic neuropathy after neck dissection

There are only 2 published cases of anterior ischemic optic neuropathy (AIO N) occurring after neck dissection, to our knowledge. We report a case of b ilateral AION following neck dissection, discuss the differential diagnoses , and compare the features of this case with those of previously described cases. There were none of the previously described risk factors for the dev elopment of AION after head and neck surgery (eg, hypotension, facial edema . or sudden massive hemorrhage) in this case, but there was prolonged diffu se postoperative bleeding. Also, the symptoms did not arise before the fift h postoperative day as they did in the other cases. Prolonged, mild postope rative bleeding is a risk factor for AION, Visual loss during the entire fi rst postoperative week has to be regarded as a complication of surgery, req uires the exclusion of several differential diagnoses, and must not be conf ounded with the patient's confusion or symptoms of withdrawal.