Background: We report a case of patient who underwent bilateral eyeball tattoo procedure for cosmetic purpose complicated with intraocular dye injection which led to ocular inflammation, secondary glaucoma, and cataract.

Methods: A 21-year-old female presented to emergency department with severe right eye pain and photophobia 21 days after conjunctival tattooing procedure. Slit-lamp examination revealed right-sided eyelid edema and black deposits of tattoo ink under the bulbar conjunctiva. Dye deposits were also present in anterior chamber, covering corneal endothelium, iris and anterior lens' capsule. Ocular inflammation and secondary glaucoma were diagnosed. The patient underwent surgical treatment to control ocular inflammation. Intraocular pressure remained stable after Nd:YAG iridotomy and on topical drugs. Moreover, during the follow-up, in contralateral eye, we observed "conjunctival lumps"-local hypersensitivity reaction to the dye, which were asymptomatic to the patient.

Conclusions: Eyeball tattooing complications are new challenges that ophthalmologist may have to face nowadays. We also reviewed for the first time possible complications of eyeball tattooing described in available literature.