Penetrating globe injury following periocular hyaluronic acid filler injection: A case report.

[PURPOSE] To describe a case of mechanical eye globe penetration resulting in subretinal and vitreous hemorrhages and retinal tear that occurred immediately following a periorbital hyaluronic acid (HA) filler injection, and to outline acute management and early anatomical outcome.

[OBSERVATIONS] A healthy 26-year-old female presented to the emergency department with the sudden onset of floaters in her left eye immediately after receiving a hyaluronic acid filler injection to the eyelid area. The best corrected visual acuity (BCVA) was 20/20 Snellen equivalent in both eyes. Ophthalmic examination showed a dense subconjunctival hemorrhage temporally and inferiorly in the left eye. The fundus examination revealed localized vitreous and subretinal hemorrhage along with an inferior retinal tear, confirming globe penetration. The patient was treated with laser retinopexy and topical antibiotics. Over serial follow-up, she experienced gradual symptom improvement, and imaging showed resolution of hemorrhage with well-formed laser scars. There were no signs of infection or retinal detachment.

[CONCLUSIONS AND IMPORTANCE] This case report highlights the risk of direct mechanical eye globe penetration associated with periocular HA filler injections. Early assessment and prompt ophthalmologic care are essential for saving vision and avoiding additional complications. Cosmetic professionals must follow safe injection practices and be aware of the possible complications to avoid injuries that might impair vision.