Chances of retinal artery occlusion (RAO) from upper eyelid fillers?

Question

I'm interested in getting upper eyelid fillers. I have read that fillers can cause retinal artery occlusion (RAO). All of the cases I found were injections to the upper nose bridge to augment the nose. Has there been any cases of RAO when injecting fillers to the upper eyelid? Is there a chance that it would?

Anna Chacon, MD, FAAD · Answer

Derma filler injections into the upper eyelid can cause retinal artery occlusion. Iatrogenic ophthalmic artery occlusion is associated with painful blindness, a thin choroid, brain infarction, and poor visual outcomes, particularly when autologous fat is used. If hit an artery it can either block the blood flow (thrombosis) at that site resulting in ischemia (reduction in oxygen to tissue) or tissue necrosis (cellular death), or it could travel to a more distant site (embolism) where it can cause ischemia or necrosis.

Leonard Grossman, MD · Answer

The problem is not what you’re injecting, but how you are injecting it. In general, In general, I do not recommend having fillers placed into the upper eyelid as they almost invariably cause heaviness in the eyelid and frequent swelling. In my opinion, only your own fat, which has been processed, that should go into the upper eyelid area producing natural and permanent results which if necessary can be reversed. Consider fat grafting if nothing else. I hope this helps and good luck from New York City plastic surgery

Brooke R. Seckel, MD, FACS (retired) · Answer

Thank you for your question.

Capwell retinal artery occlusion is a very rare complication of dermal filler injection, it is a devastating complication that can cause blindness.

In particular I would never inject a dermal filler into the upper eyelid because of the blood vessel anatomy near the nose from  and to the upper eyelid.

Chances of retinal artery occlusion (RAO) from upper eyelid fillers?

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