Can changing eye color boost confidence or does it pose too much risk?

Born with brown eyes but secretly always loved the look of gray eyes? Want to change your hazel eyes green?
The popularity of a cosmetic procedure called keratopigmentation, or corneal tattooing, is rising, though it was developed and is only approved in the U.S. for people who had medical issues involving their eyes, such as infections that turned corneas cloudy or eyes where part of the iris was injured.
The Wall Street Journal just reported that “some people getting the procedure say they want to look better and feel more confidence. Others did it to look more like family members. One young man changed one of his brown eyes blue to copy the mismatched eyes of his beloved Siberian husky.”
Generally, the eye change colors available are blue, brown, green, gray, taupe, honey and sand. The Guardian reported that patients most often are changing their eyes from brown to a different color.
There are two procedures to change iris color: The keratopigmentation process uses a needle or laser to cut into the cornea, then colored pigment is injected, which permanently changes the look of the color of the iris, though it’s actually the cornea that’s changed. You can also change the iris color with implants, where a cut is made in the eye by the cornea and an artificial iris is unfolded and placed to cover the natural iris.
The risks of the implant, per the academy, are reduced vision or blindness, light sensitivity, elevated pressure in the eyeball that can lead to glaucoma, cataract formation, injury to the cornea and inflammation that causes pain, blurred vision and tearing.
The risks of the eye tattooing process include harming the once-clear cornea in ways that cause it to warp, cloud or leak fluid, vision loss, light sensitivity, reaction to the dye, infection, uneven dye distribution, leaking of the dye into the eyeball and color fading, per the academy.
In late January, the American Academy of Ophthalmology warned against eye-color-changing procedures, which the group said “carry serious risk for vision loss and complication.” The U.S. Food and Drug Administration, the organization said, has only approved the procedure “for patients who are missing part or all of their iris, the colored part of the eye, due to injury or a birth defect.”
Dr. JoAnn A. Giaconi, clinical spokesperson for the academy, said the procedures are not risk-free. “With purely cosmetic surgeries on the eye, it’s just not worth the risk when it comes to your good vision.”
The academy suggests that people instead see if they are “a suitable candidate for colored contact lenses, which should only be worn as prescribed, dispensed and fitted by a qualified eye health professional,” she added.
Dr. Alexander Movshovich, an ophthalmologist whose practice Kerato claims more than 1,000 keratopigmentation cases successfully completed, bills the practice as unique: the only one that specializes in safe cosmetic eye color change. The site notes that any of the ways you’d change eye color, even colored contact lenses, have “some risks, advantages and disadvantages.” It likens the risk of the eye tattooing to that of any refractive procedure, such as LASIK.
“In the majority of cases, they are limited to symptoms of dry eye and some degree of photophobia (increased sensitivity to light). Usually, they last from days to a few weeks and are successfully treated with anti-inflammatory drops (prescribed by your doctor).”
There have also been cases where a patient deliberately had their entire eyes, including the whites, tattooed black, to achieve a look. Complication-free cases have been reported. But in 2020 model Aleksandra Sadowska reported that she was blind as a result of that procedure and doctors gave her little hope of getting her vision back.
Among critics of permanent eye color change techniques is the Vision Loss Alliance of New Jersey, which called eye tattoos a “dangerous fad” and said it could cause “permanent inflammation to the eye of the wall,” as well as “constant discomfort, blurred vision, vision loss, glaucoma, cataracts, injury to the cornea and blindness.”
Dr. Roberto Pineda, an ophthalmologist at Massachusetts Eye and Ear, has performed medical keratopigmentation for three decades. He told The Wall Street Journal that the procedure not only helps the eye’s appearance after illness or injury, but it “can also help reduce debilitating glare caused by iris or corneal damage.”
A study of 16 patients in Turkey who had keratopigmentation, published in the Beyoglu Eye Journal, said just one patient had complications, in that case leakage of pigment below the conjunctiva. Two had mild to moderate pigment loss within a year. They concluded the procedure “may have a great impact on future ophthalmic surgical practice from both therapeutic and cosmetic perspectives.”
Dr. Brian Boxer Wachler, a cornea specialist who does the procedure in Los Angeles, told the Journal there are no published reports of the cosmetic keratopigmentation causing infection. Or of vision loss in patients who had never had Lasik surgery.