We observed a patient who had central retinal artery occlusion with severely reduced visual acuity and characteristic retinal changes after cervical spine surgery under general anesthesia. In acute stage, visual acuity was slightly improved. But over course of several months, there was no improvement in visual acuity and central scotoma was remained. There were no evidences of hypotension or anemia during operation. The only presumptive cause was direct external ocular compression by horseshoe headrest. It is necessary to pay attention to eyes when prone positioning in the patients of cervical spine surgery.