title: BLIND-SIDED BY COSMETIC VEIN SCLEROTHERAPY: A CASE OF OPHTHALMIC ARTERIAL OCCLUSION.
abstract: OBJECTIVE
  Cosmetic vein sclerotherapy is increasingly used to treat varicose veins because of its effectiveness and adherence with British Pharmacopoeia specifications. We present the first documented case of ophthalmic artery occlusion resulting in panocular ischemia secondary to intravascular injection of sodium tetradecyl sulfate sclerosant in a young healthy women seeking treatment for prominent facial veins in her forehead.
  
  
  METHODS
  The patient presented with unilateral sudden loss of vision. Funduscopy demonstrated a pale retina, cherry-red spot, and sclerosant visualized directly at the macula. She underwent emergency treatment for central retinal artery occlusion followed by fundal photographs, fluorescein angiography, and optical coherence tomography.
  
  
  RESULTS
  Despite intervention, the vision remained no perception to light. Magnetic resonance imaging, echocardiography, and Doppler ultrasound were unremarkable. The patient later developed neovascular sequelae requiring laser pan-retinal photocoagulation.
  
  
  CONCLUSIONS
  Widely regarded as safe, and approved by the U.S. Food and Drug Administration, the only published ocular side effects of foam sclerotherapy are transient visual disturbances or temporary scotomas. This case demonstrates irreversible loss of vision as a previously unreported complication. While undoubtedly rare, we believe physicians and surgeons using sclerosant in the orbital adnexa, face, nose, and sinuses should be aware of this sight-threatening complication of injection and counsel potential patients accordingly.
authors.affiliation: Department of Ophthalmology, Imperial College Healthcare NHS Trust, London, United Kingdom.
authors.forename: Meena
authors.initials: M
authors.lastname: Arunakirinathan
authors.forename: Robbie J E
authors.initials: RJE
authors.lastname: Walker
authors.forename: Noor
authors.initials: N
authors.lastname: Hassan
authors.forename: Sally
authors.initials: S
authors.lastname: Ameen
authors.forename: Saad
authors.initials: S
authors.lastname: Younis
mesh_terms: D000328:Adult; D001157:Arterial Occlusive Diseases / Q000139:chemically induced*; D001766:Blindness / Q000139:chemically induced*; D003357:Cosmetic Techniques / Q000009:adverse effects*; D005260:Female; D005546:Forehead; D006801:Humans; D009880:Ophthalmic Artery; D015356:Retinal Artery Occlusion / Q000139:chemically induced; D012597:Sclerosing Solutions / Q000009:adverse effects*; D015911:Sclerotherapy / Q000009:adverse effects*; D012981:Sodium Tetradecyl Sulfate / Q000009:adverse effects*
chemical_list: D012597:Sclerosing Solutions; D012981:Sodium Tetradecyl Sulfate