A case of episcleral tattooing – an emerging body modification trend

Husam El Galhud · Adam Bates

23 citations0/0 files storedBMC Ophthalmology

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Tattoo and Body Piercing Complications Ocular Infections and Treatments Traumatic Ocular and Foreign Body Injuries

Abstract

BACKGROUND: In 2007 an article was published describing the first forays into the practice of episcleral tattooing. Currently only a handful of people worldwide have undergone this procedure, whereby a needle is used to inject dye under the bulbar conjunctiva. To date there have been no previous reports of the risks and complications of this emerging practice in the medical literature. We present a case involving a complication that arose in one of the few people in Britain to have undergone episcleral tattooing for cosmetic purposes. CASE PRESENTATION: A 43-year-old Caucasian man presented to the eye casualty clinic with red, lumpy conjunctivae bilaterally, having undergone episcleral tattooing 7 weeks previously. On examination there were 3 distinct areas of conjunctival swelling in each eye, representing a total of 6 injection sites. No other gross abnormalities were identified. The clinical picture remained unchanged 6 months on, apart from a degree of fading of the conjunctival dye. He will remain under our care to ensure that any further complications such as granulomatous inflammation are managed and documented. CONCLUSION: Episcleral tattooing is carried out by individuals with no medical training. The short-term complications reported so far include: headaches, severe photophobia, persistent foreign body sensation, and migration of ink staining. More serious short-term risks such as infection, globe penetration, and peri-ocular haemorrhage could occur. For now we can only speculate as to the long-term consequences, but these may include carcinogenic change or granulomatous inflammation. We feel that the potential risks of the procedure should be communicated more widely to those body modification practitioners undertaking it. This practice could result in more serious presentations to acute eye services in the future.

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2016Case series: Two cases of eyeball tattoos with short-term complications 2019Tattoo-associated complications and related topics: A comprehensive review 2019Complications of ocular tattooing: a Canadian case series 2021Dermatological and Ophthalmological Inflammatory, Infectious, and Tumoral Tattoo-Related Reactions: A Systematic Review 2018The girl with the eyeball tattoo—what the ophthalmologist may expect? Case report and a review of literature 2019Conjunctival tattoo with inadvertent ocular globe penetration and vitreous involvement: Clinico-pathological correlation and scanning electron microscopy X-ray microanalysis 2017Conjunctival tattoo: report on an emerging body modifcation trend 2021Two cases of pen ink scleral tattoos and a brief review of the literature

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