He would then put China ink into the instrument and tattoo with a needle. Another physician, Armaignac, used a small funnel that he fixed to the cornea by three small points. He found that this electrical needle operated more rapidly and reliably than traditional methods of tattooing.
In 1901, Nieden introduced a method that used a tattooing needle based on the idea of a fountain pen, or something similar to the Edison electric pen. He created a bundle of needles to tattoo the eye, instead of using a single needle De Wecker found this method to be more practical. Some created new instruments to enhance the tattoo process. Ziegler cites several physicians who contributed to the development of corneal tattooing. His method has influenced all subsequent methods. He applied cocaine to the eye as a topical anesthetic, coated the cornea with a thick solution of ink, and inserted pigment into the corneal tissue obliquely with a grooved needle. De Wecker, as he was also known, was the first to use black India ink to tattoo a leukoma of the eye. Development of procedures Īfter Galen's reference to corneal tattooing in the 2nd century, the practice is not mentioned until 1869, when oculoplastic surgeon Louis de Wecker introduced a new method. This procedure was probably used only on those patients with an unsightly corneal leukoma. Other sources have mentioned that Galen might have used copper sulphate. This would then stain the cornea, correcting the cosmetic appearance for the patient. After the cauterization, they would apply the dye to the eye, using a variety of dyes, such as powdered nutgalls and iron (see iron gall ink) or pulverized pomegranate bark mixed with copper salt. Both physicians would cauterize the corneal surface with a heated stilet. Galen of Pergamum, a Roman physician and philosopher, first described corneal tattooing in 150 AD, and the same procedure was later described by Aetius in 450 AD as an attempt to mask the leucomatous opacities of the eye. History Ĭorneal tattooing has been practiced for almost 2000 years, first mentioned in history by Galen, a 2nd-century physician. Keratopigmentation for aesthetic purposes is an intervention performed in patients who want to change the color of their eyes. Corneal tattooing is also performed on patients who still have vision to reduce symptomatic glare associated with large iridectomies or traumatic iris loss. Samuel Lewis Ziegler, indications for treatment include albinism, aniridia, coloboma, iridodialysis, keratoconus, or diffused nebulae of the cornea. Occasionally, corneal tattooing is performed when it might improve eyesight. Most physicians agree that the procedure should be performed only on patients who have lost their vision or who do not expect to recover it. Tattooing the cornea can alter a discoloration, blending an opacity into the normal eye color. Such opacities can be cosmetically disruptive for patients in their everyday lives. Corneal opacities (scarring of the cornea that creates an opaque or semi-transparent area on the eye) may be caused by leucoma, keratitis or cataracts. Usually, the need for this alteration stems from corneal opacity. The leading reason for corneal tattooing is to alter the appearance of the eye cosmetically. Corneal opacities are the leading reason for undergoing cosmetic tattooing. Others receive treatment for optical purposes, including decreasing circumstantial glare within the iris. Most patients receive treatment to alter the cosmetic appearance of their eyes following disease or accident. Causes or reasons for corneal tattooing vary from patient to patient.
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