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Complete recovery of filler-induced visual loss following subcutaneous hyaluronidase injection
Authors:Siti Nurhuda Sharudin  Mohamad Fathi Ismail  Suresh Kumar Vasudevan
Institution:1. Department of Ophthalmology, University of Malaya Medical Centre, Kuala Lumpur, Malaysia;2. Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia;3. Department of Ophthalmology, Hospital Sultanah Aminah, Johor Bahru, Johor, Malaysia
Abstract:The rise in popularity of hyaluronic acid (HA) dermal filler injection has caused an exceptional increase in the number of cases of reported irreversible blindness. Here, we reported a case of ischemic optic neuropathy and ophthalmoplegia following subcutaneous HA filler injection with complete visual recovery. A 31-year-old Chinese woman presented with sudden onset of right monocular visual impairment associated with diplopia. Patient had received a hyaluronic acid-containing ?ller injection for nasal dorsum augmentation twelve hours prior to presentation. Visual acuity of the right eye was counting finger. A right relative afferent pupillary defect was demonstrated with ophthalmoplegia. Humphrey visual field test disclosed a right inferior altitudinal field defect with impairment of colour vision. Computed tomography of the orbit revealed mild enlargement of the right medial and inferior recti muscles. Our patient showed a tremendous improvement of vision after a subcutaneous hyaluronidase injection with complete visual recovery within 2 weeks.
Keywords:Hyaluronic acid injection  ischemic optic neuropathy  ophthalmoplegia  hyaluronidase
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