Unusual Tattoo-Associated Uveitis After Cosmetic Eyebrow Tattooing: A Case Study and Narrative Review.

PURPOSE: To report a case of unusual tattoo-associated uveitis following cosmetic eyebrow tattooing.

METHOD: Case report with review of relevant literature.

RESULT: A 37-year-old Chinese female presented with worsening blurring of vision and painful red right eye following repeated cosmetic eyebrow tattooing, which had caused local swelling and bleeding at the eyebrow tattoo site. Right visual acuity was 6/60. Ophthalmic examination showed right eye panuveitis with cystoid macular edema. A diagnosis of tattoo-associated uveitis was made after exclusion of other identifiable causes, including systemic sarcoidosis. Due to the severe, chronic and relapsing ocular inflammation, treatment was escalated from topical steroid, periocular corticosteroid, and low-dose systemic corticosteroid to higher-dose systemic corticosteroid, and ultimately immunosuppressive therapy to achieve clinical remission. She subsequently developed posterior subcapsular cataract, with final visual acuity improved to 6/18.

CONCLUSION

Tattoo-associated uveitis following cosmetic eyebrow tattooing is an uncommon but likely underdiagnosed clinical entity. Ophthalmologists should maintain a high index of clinical suspicion and take a thorough history, including cosmetic tattooing in patients presenting with uveitis of unclear etiology, particularly given the growing global popularity of cosmetic tattooing.