Central Retinal Artery Occlusion Following Cosmetic Blepharoplasty in a Young Patient: A Case Report

The purpose of this study is to report a case of unilateral central retinal artery occlusion (CRAO) as a rare ophthalmic complication following bilateral cosmetic blepharoplasty in a young patient and to highlight its probable causes, management, and preventive considerations.

A 31-year-old gentleman, with no known comorbidities, presented with complaints of vision loss in the left eye for 6 weeks after undergoing bilateral cosmetic blepharoplasty. At presentation, the best corrected visual acuity (BCVA) was 20/25 in the right eye (OD) and no perception of light (NPL) in the left eye (OS). Intraocular pressure (IOP) was 14 mmHg in both eyes (OU). Pupillary examination revealed a round, regular, and reactive pupil in the right eye, whereas the left pupil was mid-dilated and nonreactive, with a positive relative afferent pupillary defect (RAPD). The fellow eye remained asymptomatic following surgery.

At presentation, optical coherence tomography (OCT) was performed, and it demonstrated marked thinning of the inner retinal layers, consistent with chronic CRAO in the left eye. Given the rarity of CRAO in young individuals, a comprehensive systemic workup was performed, including hematological, inflammatory, coagulation, autoimmune, and cardiac evaluations. All investigations were within normal limits.

CRAO can occur as a rare postoperative complication of cosmetic blepharoplasty. Early recognition, prompt management, and careful postoperative monitoring may prevent the risk of such complications.