Non-postoperative Central Retinal Artery and Ophthalmic Artery Occlusion With Compression Ischemia Due to Prolonged Sedation In Prone Position

Abstract

Central retinal artery occlusion (CRAO) after a prolonged period of lying prone is a rare condition with only a handful of cases reported, generally as a postoperative complication of spinal surgery. Only a few cases can be found describing acute visual loss following intravenous drug abuse and stupor leading to continuous pressure on the orbit while asleep. No cases can be found describing acute visual loss following the ingestion of oral sedating/antipsychotic medications. Urgent identification and workup with subsequent interventions are needed to offer the highest probability of full/partial visual restoration. Our patient presented with complete vision loss after ingesting oral antipsychotic medications leading to a prolonged sedated state in which compressive ischemia led to central retinal artery occlusion. The complex timeline regarding the patient's presentation and the implications relating to offered interventions are highlighted in this case report.

Keywords: acute vision loss; blind; central retinal artery occlusion; hyperbaric oxygen therapy; intravenous drug use (ivdu); mri images; neuro-ophthalmology; prescription drugs; retinal injury; stroke.