• Katie Beleznay, Jean D A Carruthers, Shannon Humphrey, and Derek Jones.
• Departments of *Dermatology and Skin Science, and †Ophthalmology and Visual Science, University of British Columbia, Vancouver, British Columbia, Canada; ‡Skin Care and Laser Physicians of Beverly Hills; §Division of Dermatology, University of California at Los Angeles, Los Angeles, California.
• Dermatol Surg. 2015 Oct 1; 41 (10): 1097-117.

BackgroundAs the popularity of soft tissue fillers increases, so do the reports of adverse events. The most serious complications are vascular in nature and include blindness.ObjectiveTo review the cases of blindness after filler injection, to highlight key aspects of the vascular anatomy, and to discuss prevention and management strategies.MethodsA literature review was performed to identify all the cases of vision changes from filler in the world literature.ResultsNinety-eight cases of vision changes from filler were identified. The sites that were high risk for complications were the glabella (38.8%), nasal region (25.5%), nasolabial fold (13.3%), and forehead (12.2%). Autologous fat (47.9%) was the most common filler type to cause this complication, followed by hyaluronic acid (23.5%). The most common symptoms were immediate vision loss and pain. Most cases of vision loss did not recover. Central nervous system complications were seen in 23.5% of the cases. No treatments were found to be consistently successful in treating blindness.ConclusionAlthough the risk of blindness from fillers is rare, it is critical for injecting physicians to have a firm knowledge of the vascular anatomy and to understand key prevention and management strategies.

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