One of the complications of filler is the blocking of blood vessels, known as a vascular occlusion. The physical space occupied by the fillers and constrict the blood vessels if it’s too close to them. If blocked then the area that they supply blood to is cut off causing a type of tissue death known as necrosis. But is this a risk that can lead to blindness when performing tear trough fillers?
To answer this we need to look at the location of the procedure and the anatomy of the area. The artery that is closest to where tear trough fillers are injected supplies the skin around the eyes and face, not your vision. The artery that supplies the retina in your eye is located on the nose, far away from the site of injection for tear trough filler.
My personal preference for administering tear trough filler is to use a cannula. This is both blunt and flexible so it is far more likely to bounce off important structures rather than pierce them.
Some concerns were raised by Dr Gavin Chan of the Victorian Cosmetics Institute some years back with a viral YouTube video. He and Dr Mobin Master showed images of patients who had prolonged puffiness around the tear trough that wouldn’t dissolve. The MRI scans showed that some filler had entered a space that was no longer easily accessible in order to dissolve it. What’s important to note about this is that blindness was not ever seriously considered as a risk.
On the balance of things, although there are risks inherent in any procedure, blindness isn’t one you ought to be worried about if you have a competent injector.
