Patient Safety Alert: Eye Injuries After Facial Fillers

Reduce your risk of injury to delicate areas of the face by seeking care from a board certified dermatologic surgeon.

Facial fillers are wildly popular in the United States with side effects usually limited to bruises or swelling of the skin. However, adverse effects do happen — with more occurring when cosmetic procedures are performed outside the traditional medical setting by non-physicians.

Eye (ocular) injuries after facial dermal fillers are rare, but a new study points out they can be devastating when inadvertently injected into blood vessels.

A bruise will go away, but vision loss is permanent.

The study, “Characterizing Ocular Adverse Events After Facial Dermal Filler Injection—Reviewing the MAUDE Database,” published in the June 2022 issue of Dermatologic Surgery, looks at all reported ocular injuries after dermal fillers were injected in the face from Oct. 1, 1980, to Oct. 1, 2020, in the U.S. FDA Manufacturer and User Facility Device Experience (MAUDE) database.

Findings reveal 57 unique reports containing a total of 85 affected patients with ocular injury more frequently reported after hyaluronic acid (HA) filler injection (75.4%), followed by calcium hydroxyapatite (15.8%) and poly-L-lactic acid (8.8%).

Patient-reported Signs and Symptoms of Ocular Injury After Facial Fillers:

  • Visual “disturbance” (including loss of vision, change in vision, blurred vision and/or double vision)
  • Pain
  • Headache
  • Periorbital skin changes (including edema, erythema, duskiness, livedoid appearance and/or frank necrosis)
  • Concurrent stroke-like symptoms

Risk of Eye Injury From Filler Injection:

Because of the intricate web of small arteries around the eye area, an improper injection can lead to the blockage of a blood vessel that supplies blood to the eye. When the blood is prevented from reaching the eye, vision loss and even blindness can result.

“Dermatologic surgeons have extensive medical training, including facial  anatomy, and are especially careful to avoid important blood vessels near the glabella, temple and nose,” said Sue Ellen Cox, MD, ASDSA President.    

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