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Case Reports
. 2024 Jan 19;12(1):e5494.
doi: 10.1097/GOX.0000000000005494. eCollection 2024 Jan.

Injection-related Visual Compromise

Alejandra Santiago Díaz  1 , José Raúl Montes  2 , Ileana Nieves Martinez  1
Affiliations
Case Reports

Injection-related Visual Compromise

Alejandra Santiago Díaz et al. Plast Reconstr Surg Glob Open. .

Abstract

The global market for hyaluronic acid (HA)-based dermal fillers has experienced substantial growth, providing patients with an effective nonsurgical cosmetic option. According to the global market report, the HA dermal fillers market size is expected to grow to $8.5 billion in 2027 at an annual growth rate (CAGR) of 8.9%. However, despite their popularity, HA injections are not free of complications. Vascular occlusion, particularly involving the central retinal artery, represents a significant risk. This case report presents a 60-year-old woman who presented with binocular vertical diplopia after HA filler injection in the right tear trough area. Upon evaluation, the patient exhibited right hypertropia, suggesting right inferior rectus paresis due to vascular injury of the infraorbital artery. Prompt management with hyaluronidase and oral steroids resulted in the resolution of double vision. This case highlights the importance of recognizing potential complications during HA filler injections and emphasizes the need for early intervention to minimize adverse effects.

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Conflict of interest statement

The authors have no financial interests to disclose in relation to this article.

Figures

Fig. 1.
Fig. 1.
Red mark at right inferior periorbital area represents the area of injection of HA by dermatologist.
Fig. 2.
Fig. 2.
Motility examination. RHT, right hypertropia; XT, exotropia; PD, prism diopter.
Fig. 3.
Fig. 3.
Right tear trough skin ultrasound. A, B, Skin ultrasound showing hypoechoic areas corresponding to persistent HA material at the right tear trough area.
See this image and copyright information in PMC

References

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