With the increase in popularity of the use of cosmetic fillers in plastic and esthetic surgery, the possibility of severe ocular complications should not be neglected. Permanent visual deterioration, one of the most severe complications associated with the use of cosmetic fillers, can be the result of ophthalmic artery occlusion (OAO), generalized posterior ciliary artery occlusion (generalized PCAO) with relative sparing of the central retinal artery, central retinal artery occlusion (CRAO), localized PCAO, branch retinal artery occlusion (BRAO) and posterior ischemic optic neuropathy (PION). Another classification includes diffuse occlusions (OAO, generalized PCAO, CRAO) and localized occlusions (localized PCAO, BRAO, PION) [
1,
2]. Autologous fat injections are associated with diffuse occlusions, such as OAO [
1] and central retinal artery occlusion [
3], and are therefore characterized by more severe clinical symptoms and poorer visual prognosis when compared to other facial fillers. The proposed underlying mechanism assumes intravascular injection and retrograde embolization of the filler, as the injected bolus may overcome arterial pressure and move against the direction of blood flow [
3,
4]. When the injector releases the plunger, the filler travels with blood flow and enters the ophthalmic artery and its branches. With higher injection pressures, filler particles may be pushed further retrograde and enter the brain circulation, which in turn results in cerebral infarction. Autologous fat is the most common filler type to cause iatrogenic blindness, being responsible for almost 48% of the cases of cosmetic filler-induced visual loss reported in the literature up to the present [
3]. Ocular complications occur most frequently after injection to the glabellar area, nasal region, nasolabial fold and forehead. However, due to the complex vascular anatomy of the face, essentially any location of the facial region may be at risk of ocular complications. Ocular symptoms most commonly include: sudden unilateral vision loss, ocular pain and headache, which are most likely to occur immediately after injection. Visual loss may be accompanied by ophthalmoplegia and ptosis [
2,
3,
5,
6]. Although recovery from ophthalmoplegia and ptosis is observed in the majority of cases, vision loss is usually permanent. From 47 cases of ocular complications following autologous fat injections reported in the English language literature up to 2015, 38 cases resulted in complete vision loss [
5]. In 5 cases, some remaining visual acuity was observed, varying from light perception to 20/40 at follow-up, but no improvement was observed in any of the reported cases, despite the application of various management strategies [
5]. Although several treatment options have been proposed and reported [
1,
2,
5,
6], until now no treatment has been proved to be effective. As results are usually unsatisfactory, there is little to no evidence for improvement with any proposed treatment. Therefore, we present here a report of a case of visual acuity recovery from complete visual loss with no light perception caused by ophthalmic artery occlusion of the right eye following autologous fat injection in the facial area.