• Katie Beleznay, CarruthersJean D AJDADepartment of Ophthalmology, University of British Columbia, Vancouver, BC, Canada., Shannon Humphrey, Alastair Carruthers, and Derek Jones.
• Department of Dermatology, University of British Columbia, Vancouver, BC, Canada.
• Aesthet Surg J. 2019 May 16; 39 (6): 662-674.

BackgroundSudden loss of vision secondary to filler treatments is a rare but catastrophic complication.ObjectivesThe aim of this study was to update the published cases of blindness after filler injection that have occurred since we published our review of 98 cases in 2015, and to discuss prevention and management strategies.MethodsA literature review was performed to identify all cases of visual complications caused by filler injection identified between January 2015 and September 2018.ResultsForty-eight new published cases of partial or complete vision loss after filler injection were identified. The sites that were highest risk were the nasal region (56.3%), glabella (27.1%), forehead (18.8%), and nasolabial fold (14.6%). Hyaluronic acid filler was the cause of this complication in 81.3% of cases. Vision loss, pain, ophthalmoplegia, and ptosis were the most common reported symptoms. Skin changes were seen in 43.8% of cases and central nervous system complications were seen in 18.8% of cases. Ten cases (20.8%) experienced complete recovery of vision, whereas 8 cases (16.7%) reported only partial recovery. Management strategies varied greatly and there were no treatments that were shown to be consistently successful.ConclusionsAlthough the risk of blindness from fillers is rare, practitioners who inject filler should have a thorough knowledge of this complication including prevention and management strategies.Level Of Evidence: 5© 2019 The American Society for Aesthetic Plastic Surgery, Inc. Reprints and permission: journals.permissions@oup.com.

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