A case is presented of a 70-year-old white male who underwent a bilateral cosmetic lower lid blepharoplasty with fat removal. He subsequently developed a right orbital haemorrhage which resulted in the occlusion of the central retinal artery. The patient had no light perception with his right eye for approximately 1 hour, but vision was eventually restored to 20/20 after emergency therapeutic measures. There are many possible causes of visual loss following blepharoplasty, with orbital haemorrhage being the most common. Visual loss secondary to blepharoplasty can be prevented in the preoperative, intraoperative, and postoperative phases of surgery. Blindness as a complication of cosmetic blepharoplasty can be reversible if recognised early and treated appropriately. These facts must be kept in mind by all surgeons who perform blepharoplasties.
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