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Updated: Mar 24, 2026

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Management of Visual Loss Following Hyaluronic Acid Filler Injections: An Algorithm-based Approach.

Philippe Snozzi1,2, Jani A J van Loghem2,3, Ha Nguyen4,5

  • 1From the Smoothline, Zurich, Switzerland.

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|March 23, 2026
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Summary
This summary is machine-generated.

Hyaluronic acid (HA) filler injections can cause vision-threatening retinal artery embolism. This guide provides evidence-informed, stepwise algorithms for managing this rare complication in both outpatient and in-hospital settings.

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Area of Science:

  • Ophthalmology
  • Dermatology
  • Medical Aesthetics

Background:

  • Hyaluronic acid (HA) filler injections are linked to rare but severe vision-threatening retinal artery embolism.
  • Current management strategies lack high-level evidence, relying on case reports and small series.
  • Ethical and practical limitations hinder randomized controlled trials for this complication.

Purpose of the Study:

  • To provide evidence-informed recommendations for managing central retinal artery occlusion (CRAO) post-HA filler injection.
  • To offer structured, stepwise treatment algorithms for aesthetic practitioners and in-hospital specialists.
  • To guide clinical decision-making in managing this rare but critical adverse event.

Main Methods:

  • Development of stepwise treatment algorithms based on published reviews and expert opinions.
  • Incorporation of authors' clinical experience into the management guidelines.
  • Structuring algorithms into two tiers: outpatient and in-hospital management.

Main Results:

  • Presentation of sequential algorithms for managing HA filler-induced CRAO.
  • Algorithms are organized into outpatient and in-hospital management phases.
  • Provides clear guidance for clinicians facing this challenging scenario.

Conclusions:

  • These guidelines offer informative, evidence-informed recommendations for managing HA filler-induced CRAO.
  • Intended as a basis for treatment and discussion among clinicians.
  • Aims to provide clarity and support for managing this rare complication.