Complete Recovery of Filler Induced Visual Loss Following Subcutaneous Injection of Hyaluronidase

Author: Mike Clague Aesthetic Nurse BSC   Date Posted:6 November 2018 

Reversal of blindness with hyaluronidase in the nose

Thanks for taking the time to invest in your knowledge. Keeping up with clinical publications is hard. At FacecoachLIVE we hope to help you stay safe.

This paper was a review of a case of blindness that was reversed with a subcutaneous injection of hyaluronidase into the nose.  

Siti Nurhuda Sharudin et al ; July 2018

To get this paper click here - Neuro-Opthalmology -


A 31 year old Chinese woman was injected with HA filler into the dorsum of the nose and glabella for nose augmentation. She was injected 12 hours prior to presentation. She presented with mono-ocular visual impairment associated with diplopia.

She experienced severe right peri-orbital pain immediately after injection followed by severe vision loss in the inferior half of her visual field.


The patient was treated 12 hours after injection with the HA filler with 60 units of hyaluronidase across the dorsum of the nose and glabella. 

The patient experienced visual recovery at 2 weeks.  The authors discussed some limitations of the case study but it is a promising publication. 

We recommend you read this article. 



If you are in Australia you should attend our 'Safety with Dermal Fillers Workshop' in 3 hours we cover all the latest published data on blindness and dermal fillers.  

You should keep current and read your clinical publications. Revise important anatomy. Know your limitations. 

If you are doing training, check your trainers experience. At Facecoach LIVE our trainers have at least 10 years experience in medical aesthetics.  Do your research as to which training company offers you the best outcomes for your patients. 

We teach in our classes (ASSOC PROF GOODMAN) -

  • Keep your needle tip moving at all times
  • Consider a large bore 22g cannula in areas that are risky
  • Do not treat noses or glabellas with dermal fillers, it just isn't safe
  • Inject slowly, gentle pressure on the plunger
  • Inject small amounts less than 0.1ml, big boluses are bad medicine
  • Aspirate if you want to but understand it has proven unreliable in 3 published studies.  If you aspirate and see blood then you wouldn't proceed. If you aspirate and don't see blood don't assume that means you can inject a large bolus of filler immediately after. 
  • Avoid semi-permanent and permanent fillers - if you can't take it out, don't put it in

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