Scleral tattooing, commonly known as eyeball tattooing, is a form of extreme body modification designed to permanently change the color of the eye’s white portion, the sclera. This procedure involves injecting highly concentrated pigment directly into the eye’s delicate outer layers. The aim is to allow the ink to spread and stain the dense, white fibrous tissue of the sclera. This practice is distinct from traditional skin tattooing and is a high-risk, non-medical procedure sought for aesthetic purposes.
The Scleral Tattooing Procedure
The technique involves multiple injections of ink using a fine needle, typically a syringe, into the subconjunctival space, located just beneath the conjunctiva, the thin, clear membrane that covers the sclera. Unlike traditional tattoos, the goal is for the pigment to pool and gradually disperse across the sclera’s surface.
The procedure is most often performed by body modification artists, not licensed ophthalmologists or medical professionals, leading to a lack of standardized technique. The eye is a delicate organ, and the margin for error is virtually nonexistent. Injecting the needle at an incorrect depth, using too much ink, or failing to dilute the pigment can cause immediate, irreversible damage to internal eye structures.
Acute Health Consequences
The immediate aftermath frequently involves severe acute health consequences requiring emergency medical attention. A common complication is chemosis, the severe swelling of the conjunctiva, often causing the eye to appear gelatinous. Injecting a foreign, often unregulated, material into the eye also introduces a high risk of acute infection.
A devastating infection known as endophthalmitis can occur if bacteria contaminate the ink or injection site, leading to inflammation inside the eyeball. This aggressive infection can rapidly destroy eye tissue and necessitate immediate, intensive antibiotic treatment. Incorrect needle placement or excessive ink volume can also cause a sudden spike in intraocular pressure, potentially triggering acute glaucoma.
Patients frequently experience significant bruising, or subconjunctival hemorrhage, which is a pooling of blood beneath the conjunctiva. Ink migration and leakage are common, where the pigment oozes from the injection site or spreads to surrounding tissue, leading to blurred vision and discharge. These symptoms manifest shortly after the procedure, indicating immediate physical trauma and a severe inflammatory response.
Permanent Vision Loss and Chronic Issues
The long-term, irreversible complications are a primary concern for ophthalmologists. The most severe consequence is permanent vision loss, ranging from severely decreased vision to complete blindness. This loss can result from damage to the optic nerve caused by sustained high intraocular pressure or from ink particles migrating to and damaging the retina.
The retina, the light-sensitive tissue at the back of the eye, is susceptible to damage if the needle penetrates too deeply, potentially causing a retinal detachment. Chronic inflammation is a frequent issue, manifesting as uveitis or scleritis—painful, long-term inflammatory conditions within the eye’s middle or outer layers. Persistent inflammation can lead to the formation of granulomas, small masses of immune cells that accumulate around the foreign ink particles.
Patients frequently report chronic photophobia, or extreme sensitivity to light, and a constant, uncomfortable sensation that a foreign object is in the eye. In tragic outcomes, the eye may become so irreversibly damaged, painful, or chronically infected that the only remaining medical option is enucleation, the surgical removal of the entire eyeball. The dyed sclera permanently obscures the natural color cues an ophthalmologist uses to diagnose systemic diseases like jaundice or local conditions like inflammation, complicating future eye examinations and medical diagnosis.
Lack of Medical Standardization and Professional Warnings
The procedure is not recognized as a legitimate medical or cosmetic practice, and there is no medically approved technique or standardized protocol for its performance. The inks used are not regulated by health authorities, such as the Food and Drug Administration (FDA), and have not been tested for safety or biocompatibility within the human eye. These pigments are often industrial-grade materials similar to those used in printing or car dyes, posing an unknown toxicity risk upon injection.
Since this practice falls outside the realm of traditional body art, there is no formal training, licensing, or certification process for the individuals who perform it. Major medical organizations, including the American Academy of Ophthalmology, have issued strong warnings advising the public against the procedure due to the unacceptable risks of permanent vision loss. In response to mounting medical evidence of harm, several jurisdictions, including states like Oklahoma and Indiana and provinces like Ontario and Saskatchewan, have legislatively banned the practice, highlighting its inherently unsafe nature.