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Low blood pressure and anemia are cited as perioperative complications in nearly all reports of PION, which suggests a causal relationship. However, while low blood pressure and anemia are relatively common in the perioperative setting, PION is exceedingly rare. Spine and cardiac bypass surgeries have the highest estimated incidences of PION, 0.028% and 0.018% respectively, and this is still extremely low.[8][15][16] This evidence suggests that optic nerve injury in PION patients is caused by more than just anemia and low blood pressure.[14]In both types of PION, decreased blood flow leads to the death of optic nerve cells.

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