Injection of a soft tissue filler for aesthetic purposes can result in arterial embolism and loss of vision. Severe cases can result in complete blindness.

Soft tissue filler may include:

(1) a dermal filler (hyaluronic acid, other)

(2) fat


High risk injection areas:

(1) periosteum layer of the glabellar region

(2) sub-superficial muscular aponeurotic system layer of the nasal dorsum

(3) nasolabial fold


Embolic patterns include:

(1) ophthalmic artery occlusion

(2) central retinal artery occlusion

(3) branch retinal artery occlusion


Clinical features:

(1) vision loss soon after the procedure

(2) variable signs of stroke (limb weakness, etc)

(3) variable skin ischemia

(4) pain

(5) variable ophthalmoplegia

(6) variable ptosis

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