Ophthalmic artery: why it matters in facial harmonization
- Artery
Quick facts
- Origin
- Internal carotid artery, just after it leaves the cavernous sinus.
- Entry into the orbit
- Through the optic canal, below and beside the optic nerve.
- Main branches
- Central retinal, posterior ciliary, lacrimal, muscular, ethmoidal, supraorbital, supratrochlear and dorsal nasal.
- Link with the face
- Anastomoses with branches of the external carotid, such as the angular artery and the superficial temporal artery.
- Relevance in facial harmonization
- The route by which a filler embolus can reach the retina and, more rarely, the brain.
The ophthalmic artery is the artery that supplies the eye and the contents of the orbit. It arises from the internal carotid, enters the orbit through the optic canal and gives branches to the retina, the eye muscles and the lacrimal gland, as well as branches that leave the orbit and supply the forehead, glabella and nose. In facial harmonization, it is the bridge between the circulation of the face and that of the eye, which is why it is at the center of the discussion about filler-related blindness.
What are the branches of the ophthalmic artery?
| Group | Branches | Territory |
|---|---|---|
| Branches to the eye | Central retinal and posterior ciliary | Retina, choroid and optic nerve |
| Branches to the orbit | Lacrimal, muscular, ethmoidal | Lacrimal gland, eye muscles, nasal cavity |
| Branches to the face | Supraorbital, supratrochlear, dorsal nasal, palpebral | Forehead, glabella, eyelids, root and dorsum of the nose |
The order and pattern in which the branches leave vary considerably between people. What stays constant is the logic: the branches that reach the skin of the forehead and nose belong to the same system that supplies the retina.
How does it communicate with the face?
The face is supplied mainly by the external carotid, through the facial artery, the superficial temporal and the maxillary arteries. The ophthalmic artery comes from the internal carotid. The two networks meet at several anastomoses:
- the angular artery, the end of the facial artery, with the dorsal nasal artery, at the inner corner of the eye;
- the superficial temporal artery, through its frontal branch, with the supraorbital and supratrochlear arteries, in the forehead;
- infraorbital and malar branches with palpebral branches.
These connections are normal and important for blood supply. The problem is that they create a pathway: product injected into a vessel of the face, at a pressure higher than that of the blood, can travel against the flow all the way to the ophthalmic artery. When the pressure stops, the flow carries the embolus into the branches of the eye. More rarely, the product can reach the internal carotid and cause a stroke.
Which areas of the face are linked to this circulation?
The areas most often cited as high risk for visual complications are the glabella, the nose, the forehead, the region around the eyes and the nasolabial fold, where the angular artery rises toward the inner corner of the eye.
Technique, plane, volume and the choice between cannula and needle are decisions for the qualified professional, according to the rules of their professional council in Brazil. For the general picture, see safety and complications.
How does it show up in the assessment?
The ophthalmic artery is not examined in the aesthetic consultation, but the risk is. Record previous procedures and surgeries around the eyes, nose and forehead, and any previous visual complaint, so you have a reference if a symptom appears later.
Also called: arteria ophthalmica, artery of the eye.
Frequently asked questions
What does the ophthalmic artery have to do with facial filler?
It supplies the eye and sends branches to the forehead, glabella and nose, which communicate with arteries of the face. If filler enters one of these vessels, it can reach the ophthalmic artery and block the circulation of the retina.
Is filler-related blindness common?
No. It is a rare complication, but a very serious one and usually irreversible. That is why prevention, knowledge of anatomy and an emergency protocol are a mandatory part of injecting fillers in the face.