How can a tattoo cause blindness?
There are several ways in which a tattoo may threaten loss of vision. The most obvious situation is a scleral tattoo. This is a tattoo applied to the outer eye wall, the white sclera. The tattoo ink may have direct toxic effects on the eye and there is a risk of serious infection. However, even a skin tattoo applied far from the eyes may risk loss of vision. This is due to an autoimmune condition called tattoo granuloma with uveitis (TAGU). Autoimmune conditions occur when your own immune system attacks your body.
What are the symptoms of TAGU?
Various symptoms may be experienced depending on where the eye is most inflamed. Symptoms may be mild or they may be severe and disabling. The eye may be painful, red, tearing, and light sensitive. Tiny floating spots which move or “float” may be seen. Sometimes blind spots, blurred vision, distortion, or loss of side vision occurs. The visual symptoms are frequently associated with inflammation of the tattoo (elevation, redness, warmth, itching, tenderness and/or swollen lymph nodes).
Who is at greatest risk of TAGU?
Fortunately, TAGU appears to be a rare condition. However, risk factors that may increase the chance of TAGU include the size of the tattoo. The larger the tattoo, the greater the risk of TAGU. Also, a personal history or family history of other autoimmune conditions may increase the risk of TAGU. Other autoimmune conditions include sarcoidosis, rheumatoid arthritis, lupus, and Harada’s disease.
How is TAGU diagnosed?
The diagnosis of TAGU is first considered in anyone with inflammation of the eye (uveitis) in a person who has had a tattoo. A skin biopsy may be needed to demonstrate a typical form of inflammation of the tattoo. In addition, other tests may be needed to be sure the uveitis is not due to a problem unrelated to the tattoo (see uveitis questionnaire).
Take some time to carefully review and report to your doctor any unusual or unexplained symptoms such as rashes, back and joint problems. Tell your doctor if you travel abroad, spend time in rural settings, or may be exposed to animals or infections. Heredity may also play a role. Also, review and report your ancestry (for example, Asian, Mediterranean, or American Indian ancestry). When the doctor diagnoses uveitis, laboratory tests may be ordered to help determine its cause.
How is TAGU managed?
To limit the damage from inflammation, TAGU is treated with anti-inflammatory medication in the form of eye drops, injections (next to the eye or into the eye), or pills. When pills are used, the eye doctor frequently coordinates medical care with the expert assistance of a rheumatologist. Rarely, surgery is required to treat TAGU. In some cases, uveitis may be long-lasting. In these cases, years of therapy are needed to preserve vision. TAGU is a serious eye problem and may result in loss of vision or blindness. However, by seeing your eye doctor and taking the medications exactly as recommended, damage to your vision can be minimized.
In some cases, TAGU can resolve with treatment, but return at a future date. Therefore, if you become aware of symptoms of uveitis in the future, do not hesitate to contact your doctor.
What are other risks of tattoos?
Apart from eye inflammation, there are a host of health risks associated with tattoo. They include infection of the skin or blood (sepsis), hepatitis, HIV/AIDS, heart valve infection (endocarditis), scleroderma, scarring (keloid formation), and hypersensitivity reactions. Remember that the FDA does not regulate the contents of the ink that is injected into the skin. Also, government regulation is variable as it relates to training, sanitation, and infection control. Current regulations may not be adequate to protect you against harm.
For a telemedicine consultation with Dr Pautler, please send email request to spautler@rvaf.com. We accept Medicare and most insurances in Florida. Please include contact information (including phone number) in the email. We are unable to provide consultation for those living outside the state of Florida.
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