Sudden Bilateral Blindness Following Massive Uterine Bleeding: Reports of 2 Cases

Abstract

Background: Most cases of sudden blindness are due to vascular causes. Ischemic optic neuropathy is a rare cause of blindness reported most commonly in association with collagen-vascular diseases, infectious processes, and systemic hypotension related to massive exsanguinating hemorrhage. Aim: To report 2 cases of bilateral complete visual loss following massive uterine hemorrhage. Case Reports: Case 1 is a 23 year-old unmarried female student who first presented at our Eye Clinic on account of bilateral visual loss of 5 months duration. She had, had a septic abortion and profuse bleeding per vaginum for over a week before visual loss. Case 2 is a 39 year-old unmarried school teacher who presented on account of sudden bilateral visual loss of two months duration following myomectomy. Postoperatively, patient was transfused 4 pints of blood. Conclusion: Since sudden visual loss could follow non-ocular surgical procedures, surgeons must always be on the alert and ensure they avoid conditions that could predispose a patient to optic nerve ischemia; conditions such as perioperative drops in systemic blood pressure and hematocrit values. Normotension during and after surgery, is therefore vital in preventing optic nerve ischemia.