Researchers looking at orbital symptoms associated with blindness after hyaluronic acid (HA) filler injections write that most retinal and ophthalmic artery occlusions probably start from vessels close to the glabella, according to a study published August 2017 in Plastic and Reconstructive Surgery.
In their classification of the cases of blindness from HA fillers since 2012, the researchers reviewed patients during a six-month follow-up and categorized two patients as type I, with blindness but without ptosis or ophthalmoplegia; two as type II, with blindness and ptosis but without ophthalmoplegia; two patients as type III, with blindness and ophthalmoplegia but no ptosis; and three cases as type IV, or blindness, ptosis and ophthalmoplegia.
According to the study, five patients had received glabella injections. Three had injections in the dorsum and three in the nasolabial fold. The direct injections, done with needles, ranged from 0.1 cc to 1 cc or more.
It’s known that blindness happens after cosmetic filler injections; yet, it’s an adverse event which is generally not addressed with patients, researchers reported in 2014 in JAMA Ophthalmology.
Considered rare, blindness from facial fillers is for the most part irreversible. One pressing issue is that cases may be underreported and, with increasing filler popularity and providers offering the service, there could be an uptick in new injectors who are not aware of the varying patterns of facial vascular arborization, according to a late 2014 study in Plastic and Reconstructive Surgery.