Blindness associated with cosmetic blepharoplasty

Blindness associated with cosmetic blepharoplasty is a rare but real occurrence. Thorough ophthalmic and medical preoperative screening of patients and minimal gentle orbital surgery are necessary to decrease the incidence of this tragic complication. We must continue to try to return prolapsed orbital fat from the eyelids back into the orbit and maintain it there by reinforcing the orbital septum rather than by excising fat. Until such operative procedures are perfected, it is suggested that deep orbital injections be avoided and that patients be monitored carefully postoperatively. If an orbital hemorrhage should occur, immediate lateral canthotomy should be performed, followed by whatever other decompressing or ocular hypotensive measures may be necessary.