Amaurosis: sudden vision loss after filler
Quick facts
- Definition
- Total and sudden loss of vision in one eye, with no visible injury to the eye.
- Mechanism most often cited
- Injected material reaches the ophthalmic artery or the retinal branches by retrograde flow.
- Signs
- Intense pain, sudden vision loss or blurring, eye pain, skin changes.
- Associated areas
- Glabella, nose, tear trough, temples and nasolabial fold.
- Management
- Emergency, with immediate action and urgent referral.
Amaurosis is vision loss with no apparent injury to the eye. In the context of harmonization, the term describes sudden loss of vision after a filler, almost always associated with a vascular occlusion with retrograde embolization. It is rare, but it is the most serious complication in the field and there is no guarantee of reversal.
How does it happen?
The injected material enters a vessel and travels against the direction of flow to branches that supply the eye, such as the ophthalmic artery and the central retinal artery. The network of connections between the vessels of the face and the eye, covered in vascular anastomosis, explains why a seemingly distant point can cause the event.
Which areas call for the most attention?
| Area | Why it is cited |
|---|---|
| Glabella | Vessels that communicate with the ophthalmic system |
| Nose | Branches of the facial and ophthalmic arteries |
| Tear trough | Proximity to the inner corner of the eye |
| Temples | Deep and superficial vessels of the area |
What should be prepared?
Hyaluronidase should be available whenever hyaluronic acid is used. In addition, the professional needs a written protocol and must know whom to call and where to refer. The topic must also be in the informed consent form, in language the patient understands.
Knowing the vascular anatomy and choosing the area, product, volume and technique with caution is the foundation of prevention.
Also known as: acute visual loss, blindness after filler.
Frequently asked questions
Is amaurosis after filler common?
It is rare, but it is the most serious complication described. Its low frequency does not reduce the need for preparation: every clinic that injects hyaluronic acid must know the signs and have an emergency protocol.