20/03/2026
OMG is that a bruise or something WORSE 😱 ??
This one LOOKS scary because it’s near the eye!
This happened treating the tear trough with a 22G cannula. That means, a BIG(ish) cannula. Haven’t we been told that cannulas are safe?!
Well, here’s the facts:
- cannulas were only found to be 77% (NOT 100%!) safer than needle in a comparative study by Alam et al in 2021.
- the eye is a delicate area
- as we age, our tissues become more brittle and injuries can be caused by even blunt cannulas, especially in the presence of medical conditions.
So, what might have been injured here?
SCROLL RIGHT ➡️
You can see the angular artery and vein are right by the massive bruise. Yes, a BRUISE. This injury is likely an injury to the angular vein because of its location close to the medial aspect of the eye.
Why the vein? Well, they are easier to injure: they’re collapsible and easily poked with a sharp object. The quick presentation of this bruise means it’s likely to be a big vessel that can leak lots of blood! And it’s a big splotch, so it’s definitely a bruise. Although I will say: monitor this kind of thing, bruises CAN appear superimposed on vascular occlusions, so if it creeps or gets painful, get it checked out!
By using a little anatomy deduction you can not only work out whether your patient is in danger but also what structures are involved. This is not only useful for diagnosis but also their management. Plus, you can feel in control of the situation ❤️
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