Orbital Infarction Syndrome Following Hyaluronic Acid Lip Filler Injection

Area of Science:

• Ophthalmology
• Plastic Surgery
• Vascular Medicine

Background:

• Cosmetic procedures, such as lip filler injections, are increasingly popular.
• Complications from dermal fillers, though rare, can be severe and vision-threatening.

Purpose of the Study:

• To report the first case of orbital ischemic syndrome secondary to ophthalmic artery occlusion caused by hyaluronic acid lip filler injection.
• To raise awareness among clinicians about this rare but devastating complication.

Main Methods:

• A case report of a 31-year-old female with acute vision loss after lip filler injection.
• Clinical examination, emergent neuroimaging, and ophthalmic assessments were performed.
• Treatment included medical management (steroids, anticoagulants, vasodilators) and surgical interventions (lateral canthotomy/cantholysis, hyaluronidase injections).

Main Results:

• The patient presented with severe vision loss (no light perception), ophthalmoplegia, and ptosis in the affected eye.
• Despite prompt treatment, vision loss was irreversible, and the patient ultimately required enucleation due to intractable pain.
• Ophthalmic artery occlusion leading to orbital infarction syndrome was diagnosed as the cause.

Conclusions:

• Hyaluronic acid filler injection into the lip can lead to ophthalmic artery occlusion and subsequent orbital ischemic syndrome.
• This case underscores the critical need for awareness and careful technique during filler injections to prevent catastrophic vascular complications.
• Ophthalmologists and plastic surgeons should consider this diagnosis in patients presenting with acute vision loss after cosmetic facial procedures.