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A round-up of the eye-related hot topics that have been trending on social media over the last few weeks.


#ScleralTattoo #BlackEye

Scleral tattoos aren’t necessarily a new phenomenon. A quick google search will identify cases being in the news from as early as 2010 when the state of Illinois tried making the procedure illegal [1], unless it was administered by a doctor. Whether that was a medical doctor was not specified. Since then, with the exponential popularity of social media, more and more successful (and sometimes not!) cases are making their way to our screens. The tattoo results in completely black or dark blue sclera. TikTok has allowed users, and therefore their audiences, to gain more information on the procedure, which is otherwise quite difficult to come by unless one is actively pursuing it.

Prices hover around a whopping $5000 per eye, as reported by social media personality Quest Guildford who recently underwent the operation himself, with many outlets reporting on his new look [2]. The procedure involves a dye being injected into the subconjunctival space. Possible complications include reaction to the dye, blindness, retinal detachment, photophobia, inflammation and even enucleation [3].

Interestingly, Farrah Flawless, who has had scleral tattoos for the longest period of time worldwide, underwent a cosmetic extraocular implant procedure performed by ophthalmologists at the Netherlands Institute for Innovative Occular Surgery in Rotterdam [4]. She now has a platinum star in the lower left quadrant of her conjunctiva.

#K-Pop #Vogue #TheBleph

Staying with cosmetic oculoplastics, a Japanese K-Pop star has made headlines for undergoing a form of blepharoplasty known as ‘double eyelid surgery’. The surgically created supratarsal fold was first described in 1896 [5] and has become very popular among East Asian populations. One large cross-sectional study stated East Asia as the fastest growing region in the global market [6]. Since the early 1990s, when the aesthetic boom took off, surgical approaches and techniques have been modified to cater towards Asian values. Vogue Arabia recently covered the rise of ‘the eye lift’, another form of blepharoplasty.

The article interestingly points out the increased popularity of remote meeting apps which have given people more opportunity to closely examine their faces – I was glad to hear it’s not just me who stares at themselves in virtual meetings. Blepharoplasty is now being thought of as a long-term alternative to Botox, fillers and retinol creams, with its popularity being so high that blepharoplasty on social media is simply known as ‘the bleph’, with over 540 million views on TikTok [7].

#Arkansas #EyeTransplant

As many of you may know, a world-first eye transplant was performed in Arkansas, USA, in November 2023. The 21-hour procedure comprised 140 health professionals. The patient, a 46-year-old gentleman, suffered extreme electrical burns to his face, left eye and left arm in June 2021. Due to pain, he underwent a left enucleation. Once out of ICU and stable, discussions between the patient and specialists in New York resulted in the decision to perform a partial face transplant including the donors left eye. Donor tissue was extensive, comprising the left eye and optic nerve, the nose, left eyelid and eyebrow, lips, part of the skull, nasal, chin and cheek bones and all of the muscle and nerve tissue under the right eye. Stem cells were also transplanted into the left eye in an effort to aid optic nerve regeneration. Six months post procedure, the patient does not have vision in the transplanted eye. The case is currently undergoing the peer review process for publication, but with its exciting potential, the story has already been picked up by countless media outlets internationally [8].

#PrivateHealthcare #NHS

The Independent recently sub-headlined an article with “One woman had to pay £3000 for emergency eye treatment or risk going blind due to three-week NHS wait” [9]. However, the article did not delve further into what type of treatment was needed and what procedure this patient ultimately had. It raised an interesting debate about the current state of eye health and private pathways which patients face. Around 640,000 patients are currently waiting for NHS ophthalmology appointments in England, and the chair of the All-Party Parliamentary Group on Eye Health and Vision Impairment raised concerns about the UK being the only country without an eye health strategy, despite a worrying backlog [9]. There are several reasons why so many patients are waiting and it could be an entire article in itself. The President of the Royal College of Ophthalmologists (RCOphth) recently shared concerns that ophthalmology may become like dentistry, where patients face being charged for services.

The comments sparked backlash from the Independent Healthcare Providers Network (IHPN) who argued that private sector work has actually benefited ophthalmology and “total activity is up more than 15% in 2023 as compared to 2019 – and average waits are down by as much as two weeks”, according to the IHPN CEO [10]. The caveat here as raised by the RCOphth president is the amount of cataract operations being performed in the private sector and their associated generous tariff rates, meaning “mild cataracts getting surgery at the expense of other patients going blind” [11]. The CMOs of five private providers commented that significant clinical benefits, as well as huge operational efficiencies, to the ophthalmology services are being delivered, and the insinuation that cataracts are somehow less important is concerning [11]. An ongoing long debate if ever there was one.







5. Mikamo M. Mikamo’s double-eyelid operation: the advent of Japanese aesthetic surgery. 1896. Plast Reconstr Surg 1997;99(03):664–9.
6. Kwon SH, Lao WW, Lee CH, et al. Experiences and attitudes toward aesthetic procedures in East Asia: a cross-sectional survey of five geographical regions. Arch Plast Surg 2021;48(6):660–9.





[All links last accessed January 2024].




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Akash Dharni

Sheffield Teaching Hospitals NHS Trust, UK

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