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Bulbar Conjunctival Tattooing

Q:

Dear KeraNet Members,

A 17 year old patient came into my office yesterday with her mother after having bulbar conjunctival tattooing done to both eyes four days ago with purple ink.  Pictures below.

There is one entry point in each quadrant where the “body sculpting artist” dipped a needle into ink and irrigated saline under the conjunctiva.  The left inferotemporal quadrant has 3 entry points.  There is no conjunctival defect presently.  The right cornea has a crystalline appearance in the epithelium and anterior to mid stroma.  Pannus 360 degrees OU with purple pigment up to the limbus.
Patient says it was previously very chemotic but is getting better now.  However, she regrets her decision and wants it reversed.  Any tips and recommendations?  Many thanks.
Tenley
A by Doctor Chynn:
man some people are totally nuts!:)

fortunately, he didn’t really tattoo anything, just injected colored saline between the conj and sclera
i guess you could try irrigating saline into that space, but after 4 days i doubt you would be able to get much pigment out
i would try that as you probably should at least try something, but consent her that the utility might be pretty low by now, if she came to you a day afterwards that would probably help
and then just reassure her that the body’s immune cells will chew up the pigment over time, but that will probably take months to fade out (hopefully not years like would be necessary if he actually went into the sclera)
you could also give her some mild topical steroid (eg lotemax) to help reduce the allergic reaction to the dye
good luck, and please give me follow-up in a month as to what transpires, as i am doing corneal tatooing myself, so would like to know how long it takes for the dye to resorb
thanks for sharing

 

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