Can Restylane fillers under the eyes cause a central retina occlusion?

Any injections around the eyes with a foreign substance can cause potential blindness.  Experienced injectors and those who use cannulas are less likely for this to happen, it is rare anyway.  I suggest you see someone who is an expert for treatment.  Best, Dr. Emer.

Anything is possible, but the chances of that happening are extremely low. In fact, it has never been reported in the lower eyelid area. Very rarely it has been reported with injections in forehead/nose area. The chances of someone getting into a bad car accident on your way to get the treatment is higher. Best to see an oculoplastic specialist for the eye area.

Dear AngelaFreeman:Blood vessel are tubes that start at the heart and branch in smaller and small diameter until you cannot see them as capillaries carrying platelets, red cells, white cells and other nutrients to all the structural cells in the body; and then increase in size back to the heart.Some vessels go "straight" and end at a capillary. Others are circular vessels called collaterals circumventing blood flow in the event there is a blockage. The face has many collaterals particularly around the eye. These collaterals feed blood or take away blood from inside of the skull behind the eye where the blood vessels tend to be "straight".If a blood clot stops the flow of blood in a vessel, it is called a thrombus. If another object, say a filler, fat or air enters the blood stream and causes the vessel to occlude, this is called an embolus. The advent of fillers, including: fat, Restylane, Perlane, Juvederm and dozens of others new injectables used in the rejuvenation process has enhanced the appearance of millions of people. Unfortunately, the very rare but perfect storm for a filler embolus can occur when injecting lines, creases and folds around the eye, lip nose and other areas where there are "straight" vessels. While retinal artery embolus is a devastating complication, it is also a very rare occurrence. Injection devices and techniques including:blunt cannulasdepth of injectionpressure of injection amount of filler injectedaspiration testand many other considerations in the use of injectibles. It is always best to choose a Board Certified, well experienced Plastic Surgeon, Facial ENT Surgeon, Ophthalmologist or Dermatologist who understand the anatomy and the art of the injecting region for your fillers. I hope this helps. All the best!

This is a complication that is extremely rare but there are over 100 cases of this occurring with all fillers, including fat, and not just Restylane. Minimizing this risk can be done:Experience injecting physicianUsing blunt tipped cannulas that are 25g or largerA constant movement of the cannulaSlow injection of fillerNo bolus of fillerI do this procedure about 5 times per day with cannulas and feel very comfortable doing this.  You must seek out experienced physicians for this area.  I get the most questions on Realself about bad outcomes from this injection, usually reversible.Unfortunately, blindness from this complication is not usually reversible.