Cosmetic Change of Eye Colour
Dr Jagadesh C Reddy, Consultant - Cornea, Anterior Segment and Refractive Surgery Services, L V Prasad Eye Institute, Hyderabad
Modernization and changing times have led the younger generation to explore different new ways to make themselves look more attractive. Marcus Tullius Cicero, one of Rome's greatest orators and stylists had once stated that, “The face is a picture of the mind with the eyes as its interpreter.” The color of the eyes is due to the presence of pigment (melanin) in the iris (structure present behind the cornea and regulates the quantity of light that enters the eye). Usually eye color varies from light brown to black, depending on the concentration of melanin. The color of the eye can be changed by blocking the visible melanin (iris implants on the iris or cosmetic contact lens on the cornea) or decreasing the amount of melanin (laser).
Iris implants were originally developed to treat pathologic conditions with loss of iris tissue to reduce glare and light sensitivity. In the recent years there is increase in trend to use these implants to change the color of iris for cosmetic purposes. The placement of this device requires an intraocular procedure wherein the lens is placed over the iris after making a slit opening in the cornea. The device is made of silicon and is 15 mm diameter annular iris diaphragm, 0.16mm thickness, has a central hole of 3.5 mm for the light to pass through the pupil onto the retina. We do not have long-term results published in the medical literature, but complications such as uveitis (reaction in the anterior chamber), hyphema (blood in the anterior chamber), glaucoma (increase in eye pressure), corneal endothelial damage (damage to the cells of cornea leading to whiteness of the eye), glaucomatous optic neuropathy (damage of the optic nerve because of increase in eye pressure for a long duration), and profound vision loss have been reported. The iris-lens diaphragm device was supposed to be a new approach to cosmetic ophthalmological surgery but because of sight threatening complications several ophthalmology and optometry societies have discouraged the use of these implants.
Recently, California based research group has shown that in brown eyes by disrupting the thin layer of melanin on the surface iris can lead to loss of melanin and the eye can be seen as blue instead of brown. There is no published literature about this procedure and trials are still on the way.
The most common cosmetic form of treatment used for eyes are the cosmetic soft contact lens [CSCL] or fantasy soft contact lens [FSCL]. In CSCL there is a transparent central zone and a periphery with a translucent tint that permits the iris to be seen but changes its color. The FSCL has opaque colors on the periphery that cover the original color of the iris. These are usually used only for social occasions. Inspite of their popularity, there have been negative reports regarding safety. Patients revieving these contact lenses without a prescription, with no or limited care, limited handling and wearing instructions, and no follow-up examinations end up having complications. Cosmetically tinted lenses are safe and effective when patients are properly fitted, instructions provided, and follow-up examinations are performed.
In 2015, cosmetically tinted lenses trade better over invasive surgeries like iris implants in terms of safety.