FILLER BLINDNESS: Should you do retrobulbar hyaluronidase injection? [Aesthetics Mastery Show]

What would you do if your patient started losing their sight right there on your treatment bed?
Filler blindness is every injector's worst nightmare, so it's important we prepare ahead of time to avoid panic in the moment.
In this week's Aesthetics Mastery Show, Dr Tim examines your options and asks, is retrobulbar hyaluronidase injection the right course of action? What about peribulbar block? Or is it best to leave well alone?
Let us know in the comments if you find his analysis useful.
If you struggle with anxiety about causing this kind of complication, you would definitely benefit from Dr Tim's live webinar about how to overcome complications anxiety. Register here: www.aestheticc...
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Podcast: open.spotify.c...
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[@LR-zp7et]

As an optometrist I believe that injection should be done by an specialist trained doctor or an ophthalmologist ONLY!

[@christianmoretto939]

but it's an emergency isn't ?

[@nursecane]

Thank you for this incredibly valuable content (as always).

[@lorirobertson455]

Great info as always Tim! Thank you so much!

[@ellenm4773]

It would be terrifying to go through these problems. I can only imagine 😩

[@knowyouraestheticswithcons3804]

Great job presenting this very difficult subject matter.

[@AestheticsbyPatricia]

Wonderful information Dr. Pearce. Thank you!

[@alixrashid]

Great learning points, approach and brilliantly delivered, as always. 👌
In my mind, I'd think a thick, yet flexible 22G canulla could also be a way of reducing some of the risks mentioned.
Alternatively, I wonder if a plastic 18G venous canulla could be potentially used instead? Use the needle introducer until you get through the orbital membrane and then, pull out and proceed to push the plastic blunt canulla as far back as possible. The depth of an average orbit is about 45mm. Once at that depth...flood the area with hylase. The only issue I can think with that approach would be the plastic canullas firmness to push through till the back of the orbit and not just bend upon facing any resistance.
Anyhow... Just thinking out loud.

[@vgprabhakar2008]

Brilliant presentation of the complex subject. Thank you, Dr. Tim. I think ultrasound-guided canula can reduce the risk.

[@fluffykittens4090]

Thank you! I wouldn't feel comfortable with a needle bc of the AE's you've discussed. Dr Steve Yoelin teaches a lateral canthus approach with a 22g 2" cannula, skirting the globe to the hub. In his experience a 22g cannula won't puncture the globe. What are your thoughts on this approach? Would a cannula with your anterior approach reduce AE's?

[@lynetteemery1949]

I’d try like heck to get a local eye Dr to do it. If I was over 90 minutes away from anyone qualified, I’d probably do a peribulbar block.

[@julierowland593]

Great info! Thank you!

[@izzyfoster7813]

Thoughts on ultrasound guided fillers, as practices over here are starting to adopt it now. Do you think it has a place in the future of fillers?

[@couturegalx3]

I think ultrasound guided filler is the way to go

[@justme-fw2ti]

Hi Tim, I wasn't sure where I should post this question. So I've decided to post it on this thread ..🙄 I would appreciate your feedback. Are the hylaron pens safe? Tia

[@sineadnicgearailt]

Would you really do this procedure ? Be honest !

[@rominanavarrete752]

Hola!! Subtitulo en español por favor. Gracias!

[@couturegalx3]

Can anyone explain what he meant by the volume of the supratrochlear artery being 0.085ml?

[@drluizpires]

More recent studies estimated around 12-15 minutes to lost your vision

[@DrTimPearce]

Scary !

[@rarecoral212]

😧😯

[@Marc-nc9yv]

This is crazy. First, dont do fillers there, second non CT guided retrobulbar injection is ballsy. why am I putting hyaluronidase behind eye when I didn't put filler behind the eye?