Transient Symptomatic Bilateral Optic Disc Oedema Following Lumbar Spinal Surgery— An Unusual Presentation

Abstract

Background: Optic disc oedema has various underlying pathologies, however, unless visually disabling does not usually bring a patient to the physician. The more common symptoms of headache, nausea and vomiting lead to the incidental detection of bilateral disc oedema [1]. Optic disc oedema seen following spinal surgery is usually associated with visual acuity changes and often goes by the acronym POVL (Peri/ postoperative visual loss) wherein, as the name goes, visual acuity changes are profound [2] [3] [4]. Purpose: We would like to highlight a case of transient Bilateral Optic Disc oedema following Lumbar spinal surgery maintaining normal visual acuity and attaining spontaneous resolution. Case Report: A 42-year-old female presented with transient obscuration of vision and flashes of light post an uneventful lumbar spinal surgery. Ophthalmic evaluation revealed normal visual acuity and pupils but marked disc edema right more significant than left. There was no colour vision deficit, neither any field changes. By a process of exclusion, it was likely the patient had developed bilateral disc oedema secondary to the spinal surgery. On follow-up 6 weeks and 3 months later, the oedema had completely settled and visual acuity remained at 6/6. Conclusion: Optic disc oedema can be unilateral or bilateral with some of the uncommon conditions mentioned secondary to spinal surgery, however, in those situations, visual loss has been severe and permanent. Our case is unusual in its combination of disc edema with normal acuity along with its transient nature and resolution and to our knowledge, has not been published before.