Dermal Fillers and Potential Vision Loss?

Dermal injection of cosmetic fillers into the forehead can lead to irreversible blindness, according to a study published in the May issue of JAMA Ophthalmology.

Michelle V. Carle, M.D., from the Retina-Vitreous Associates Medical Group in Los Angeles, and colleagues describe irreversible vision loss from central retinal occlusion occurring after cosmetic facial enhancement.

The authors note that although cosmetic facial fillers are not approved for use in the forehead, they are frequently used off-label for enhancement in this region. No prior reports of blindness cause by filler injected into the forehead have been published. Three cases of central retinal artery occlusion due to fillers were reported shortly after cosmetic procedures, with the assumption that the filler enters the central retinal artery via the external-internal carotid anastomoses and becomes embedded in the retinal tissues. One patient had a small amount of recovery after aggressive therapy.

"Physicians performing cosmetic enhancement procedures involving facial fillers need to be aware of this potential complication and should include significant vision loss as a possible rare complication," the authors write.

As an attorney, I can tell you that this is potentially a huge issue.  There needs to be more dissemination of information about this and more studies as well. At the very least, aesthetic physicians need to amend the consent forms with patients. They need to include "loss of vision" provisions in the consent forms if the procedure is a dermal filler in the forehead region. Although the loss of vision is rare, it is still a serious complication and it must be addressed. 

Paddy Deighan J.D. Ph.D
http://www.medicalandspaconsulting.com