Journal List > J Korean Ophthalmol Soc > v.54(8) > 1009465

Seol, Kwon, Wee, and Han: A Case of Meibomian Gland Dysfunction after Cosmetic Eyelid Tattooing Procedure



To report a case of meibomian gland dysfunction as a chronic complication of eyelid tattooing and the corneal epithelial defect as an acute complication of eyelid tattooing well healed with proper treatment.

Case summary

A 31-year-old woman presented with severe eye pain, irritation and epiphora in both eyes. The patient un-derwent an eyelid tattooing procedure 2 hours before and dark pigments were placed on the inner eyelid margin. Slit lamp examination showed conjunctival injection and inferior corneal epithelial defect in both eyes. After 2 months, dry eye symp-tom still remained although the cornea was completely epithelialized. After 1 year, the patient improved completely, but still showed decreased tear film breakup time (TBUT).


Due to the increased number of people who undergo cosmetic eyelid tattooing procedures, the number of re-ports associated with complications has increased and acute complications such as corneal epithelial defect can occur. Moreover, chronic discomfort associated with dry eye syndrome can occur when pigmentation is placed on the eyelid inner margin and lead to the destruction of meibomian glands. Thus, eyelid tattooing should be performed after careful consid-eration of possible complications.


1. Angres GG. Angres permalid-liner method: a new surgical procedure. Ann Ophthalmol. 1984; 16:145–8.
2. De Cuyper C. Permanent makeup: indications and complications. Clin Dermatol. 2008; 26:30–4.
3. Rudkin AK. Wake up with make-up: complication of cosmetic lid tattoo. Med J Aust. 2011; 20:194(12). 654.
4. Wilkes TD. The complications of dermal tattooing. Ophthal Plast Reconstr Surg. 1986; 2:1–6.
5. Moshirfar M, Espandar L, Kurz C, Mamalis N. Inadvertent pig-mentation of the limbus during cosmetic blepharopigmentation. Cornea. 2009; 28:712–3.
6. Jacob CI. Tattoo-associated dermatoses: a case report and review of the literature. Dermatol Surg. 2002; 28:962–5.
7. Moschos MM, Guex-Crosier Y. Retinal vasculitis and cystoid mac-ular edema after body tattooing: a case report. Klin Monbl Augenheilkd. 2004; 221:424–6.
8. Alexandridou A, Reginald AY, Stavrou P, Kirkby GR. Candida en-dophthalmitis after tattooing in an asplenic patient. Arch Ophthalmol. 2002; 120:518–9.
9. Kojima T, Dogru M, Matsumoto Y. . Tear film and ocular sur-face abnormalities after eyelid tattooing. Ophthal Plast Reconstr Surg. 2005; 21:69–71.
10. Franz R. Tattooing a major route of hepatitis C infection. Dermatol Nurs. 2001; 13:307–8.
11. Konuk O, Evereklioglu C, Hondur A, Unal M. Protective eye shield can prevent corneal trauma during micropigmentation for perma-nent cosmetic eyeliner. J Eur Acad Dermatol Venereol. 2004; 18:642–4.

Figure 1.
Photograph shows a severe epithelial defect at inferior cornea in the right eye (A) and in the left eye (B) on the day of cos-metic tattooing.
Figure 2.
Photograph shows cosmetic tattoo at inner margin of eyelid involving meibomian gland orifices. Lid margin injection and telangiectasis were shown in the right eye (A) and in the left eye (B) 3 days after eyelid tattooing.
Figure 3.
Photograph shows remained pigmentation at inner margin of eyelid and severe meibomian gland plugging in the right eye (A) and in the left eye (B) 2 months after eyelid tattooing.
Similar articles