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Cornea Tattoo

Tattoo pigment can be placed in the cornea just like it can on the human skin. Certain patients may require corneal tattoo to alleviate glare, haloes, ghost images and/or light sensitivity but can also be done for cosmetic reasons. Most of these patients have a history of trauma to their iris either from injury or surgery. Once the iris is torn, ripped, missing or has holes in it, the patient will have excessive light through these enlarged or secondary “pupils” causing the dramatic symptoms described above. Below are some picture examples of patients that have had iris trauma and have been referred for help with their glare and light sensitivity.

Examples of Iris defects:

Cornea Tattoo Iris Defect


Corrective Measures

There are various ways to correct these iris defects. In the past cosmetic contact lenses that are colored on the outer region have been used to cover and treat their problems. However, many patients are contact lens intolerant and cannot wear these lenses, especially elderly patients. Another way to correct this is to operate on the iris, attempting to suture the iris defect closed. This surgery requires a hospital operation and is fraught with complications of internal bleeding and is difficult to perform. There are also iris implants that are not FDA approved and therefore difficult to obtain. The surgery to implant these devices is also complicated by hemorrhage, prolonged OR time and pain.

A better way to correct this problem is the implementation of the corneal tattoo. This has been done as an office procedure over the last 40 years by placing the tattoo pigment in the cornea with a very small gauge needle. The eye is of course numbed with eye drops so that the procedure is well tolerated. It can take up to 40 minutes to precisely place all the pigment over the affected area. Post operatively the eye is covered with a bandage contact lens and it typically takes several weeks for the eye to completely heal.

Picture example of hand done needle tattoo, post op from Figure 1:

Corrective Measures

Femto Assisted Corneal Tattoo

Dr. Keith Walter has further refined this procedure by using the femtosecond laser in the office to make a small pocket in the cornea. This is the same laser used for the first part of LASIK eye surgery and doesn’t hurt and only takes a few minutes. After the pocket is made, the tattoo pigment can be placed into the pocket with a blunt spreading instrument in just a few minutes. Since there is no needle used and the incision into the pocket is small, it heals after a nap with no pain and no need for a bandage contact lens. This improved procedure takes less time, heals faster, covers more completely and lessens the chance for supplemental tattooing. Most insurance carriers provide coverage for this procedure if it is considered non-cosmetic and to provide functional relief. It can also be done for those wishing to have an alternate cosmetic iris appearance and thus would require an out of pocket fee.

Pictures of femto assisted corneal tattoo:


Day one post op (from Figure 2) after femto assisted corneal tattoo:

Pre and Post op of another patient with femto-assisted corneal tattoo:

Cornea Tattoo

To learn more about Cornea Tattoos, please read the article below:

Femtosecond laser enables faster, easier corneal tattooing