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Letter
Acute postural drop in optic nerve perfusion after vitrectomy and gas in a patient with diabetic autonomic neuropathy
  1. A Al Khaier,
  2. J C Khan,
  3. R L Burton
  1. Department of Ophthalmology, The West Norwich Hospital, Bowthorpe Road, Norwich NR2 3TQ, UK
  1. Correspondence to: Mr Burton; ted.burton{at}norfolk-norwich.thenhs.com

https://doi.org/10.1136/bjo.86.4.473

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    We report the case of an insulin dependent diabetic who suffered transient blindness as a result of a change of posture following vitrectomy surgery with injection of gas.

    This 34 year old woman with longstanding diabetic disease, postural hypotension, and proliferative retinopathy had undergone argon laser panretinal photocoagulation (PRP) to both eyes. Her right eye was amblyopic and had visual acuity of counting fingers (CF), whereas the left eye, at best, had vision of 6/12 that was frequently impaired by recurrent vitreous haemorrhage. She underwent left vitrectomy and required 30% sulphur hexafluoride (SF6) gas to support an incidental small, inferior detachment related to a round hole. The patient postured supine overnight and remained under the care of the physicians.

    The following day her vision dropped suddenly and severely on her way to the …

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