Cosmetic lid margin tattoo (or cosmetic blepharopigmentation) is increasingly purveyed in Australia by specialist beauty salons and is marketed as a form of permanent make-up. Like other forms of modern tattoo art, it is applied using an electric needle tip which oscillates at 50–150 cycles per second. Each cycle embeds a small amount of pigment into the dermis. Typically, it is performed after application of a topical local anaesthetic.
In this case, tattoo pigment was inadvertently embedded directly into the cornea. This resulted in severe conjunctivitis and a large epithelial defect. In this image, taken 1 month after the injury, the anterior corneal stroma remains stippled with tattoo pigment.