Tattoos can lead to serious eye problems
Over the past 50 years there have been at least 15 cases of people diagnosed with tattoo-associated uveitis cited in the medical literature. Uveitis is a general term describing a wide range of inflammatory diseases that produce swelling and redness within the eye, and ultimately destroys ocular tissue. The term ‘uveitis’ is used because the diseases often affect a part of the eye called the uvea. The uvea is the middle layer of the eye and it is made up of the iris, ciliary body and choroid. However, uveitis is not necessarily just limited to the uvea and it can also affect the retina, optic nerve, vitreous and lens. Uveitis is a serious condition and requires prompt treatment in order to reduce the inflammation. More severe presentations or repeated episodes of uveitis can lead to scarring in the eye and subsequent severe vision loss.
A recent paper in the American Journal of Ophthalmology by Ostheimer and co-authors reported on seven cases of bilateral uveitis and associated cutaneous changes suggestive of tattoo inflammation over a 20-month period. All patients reported no abnormal cutaneous reactions immediately after tattooing, and all had their most recent tattoo placed at least 6 months prior to the onset of the skin changes and the associated eye problems (uveitis). Each of the patients discussed in the paper had extensive areas of tattooing that contained or consisted entirely of black ink, although other papers have described skin inflammation associated with blue and red ink.
The patients in this paper who were initiated on the appropriate treatment (high dose oral steroids) displayed simultaneous improvement in both their ocular and cutaneous inflammation. Note that five of the seven patients did suffer vision-threatening ocular complications at some stage during their treatment. Tattoo excision – if the tattoo is small – can possibly play a role in the resolution of the eye problems, however this option was not offered to any of the patients discussed in this paper as the percentage of body surface area encompassed by their tattoos was deemed too extensive for subsequent skin grafting.