The "devil's touch"; visual loss and orbital surgery. A synopsis of the Mustardé Lecture, 2006.

Visual loss is a devastating complication after orbital surgery, particularly that at the orbital apex or alongside the optic nerve. The clinical characteristics of 14 such patients, representing less than 1% of orbital surgery performed, are presented and the possible mechanisms discussed. The majority of patients suffered a posterior ischaemic optic neuropathy and this is likely to be related to postoperative vasospasm induced by extravasated blood and inflammatory mediators.