Ocular Tattoos

Tattooing is a type of body modification that dates back thousands of years, with the oldest tattoo believed to be from between 3370 BC and 3100 BC, and are still a major part of many cultures worldwide.

Eye tattooing isn’t a very novel concept either. In fact, Corneal tattooing has been said to be around for 2000 years now. The scleral tattoos though have a recent history of just over a decade, with the first experimentation with scleral tattoos in 2007.

Corneal Tattoo

It is also known as keratopigmentation or keratography, It is perform to patients for 2 major reasons:

• Cosmesis: Patients with like Keratitis, leukomatous opacities, complicated cataract, etc can undergo corneal tattoing to improve cosmesis by hiding disfigurement due to scars and opacities. Similarly, Patients having difficulties with cosmetic contact lenses also go for tattooing.
• Vision: Some corneal tattoos are also made to improve visual prognosis, especially in cases of ocular albinism, Iris coloboma and aniridia.

Methods

Although many techniques exist, most commonly used are

• Direct application of dye on the corneal surface
• LASER: also known as Femto assisted corneal tattooing (FACT)
• Creating Lamellar pockets in the stroma to fill with ink

Dyes used

• Organic Dyes (Carbon impregnations or mineral dyes)
• Metallic dyes (gold or platinum chloride)

Advantages

• Permanent solution
• Good Cosmesis obtained
• Minimum recovery time
• No hassle of changing contact lenses daily
• High Patient satisfaction (95% – 98.5%)
• Reduced Glare
• Increased Visual Acuity

Disadvantages

• Permanent Problem in case of botched tattoo
• Risk of Intra-Ocular Infections
• Fading of tattoos over time – retouching required
• Risk of Corneal Erosions

Alternatives of Ocular Tattoo

Tinted prosthetic contact lenses are used to manage corneal and other ocular media opacities. For iris related pathologies, artificial iris implant such as ‘bright oculars’ can be considered.

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Eyeball Tattoo

Eyeball tattooing or scleral tattooing is a form of extreme body modification of inking the white visible part of the eye. The trend of eyeball tattooing started in 2007 when a body modification artist Luna Cobra started experimenting with scleral inking to achieve the look of the famous movie ‘Dune’.

While corneal tattooing is done by a trained ophthalmic surgeon, scleral tattooing is done by non-ophthalmic trained individuals.

Method:

The method involves injecting the dye between the conjunctiva and episclera into the conjunctival sac

Advantages: you will look different from others

Disadvantages: where do we start? The flipsides to scleral tattoos include and aren’t just limited to

• Complete and partial vision loss
• Inflammatory conditions like orbital cellulitis, conjunctival chemosis, scleritis, retinitis, endophthalmitis and panopthalmitis
• Retinal detachment
• Foreign body sensation, and coloured discharges
• Photophobia
• The effect in social life – as the darker scleral tattoos intimidate people.

Majority of eyeball tattoo recipients have reported discomfort in eyes and visual disturbances, with a lot of them developing serious vision-threatening complications. The Practice of scleral tattooing hasn’t been scientifically and medically reviewed, making it one of the most dangerous bodies modification practices, with many countries and states working towards banning the practice.

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