18/02/2026
Tattoo-associated Uveitis:
▪️Tattoo-associated uveitis is a rare condition in which patients may present with uveitis and non-caseating granulomatous inflammation of tattoos.
▪️In general, cases present with noncaseating granulomas and uveitis (especially bilateral anterior uveitis or bilateral panuveitis).
▪️Etiology:
Although the etiology is unknown, it is speculated that the condition may represent a delayed hypersensitivity reaction to tattoo pigments, or possibly a limited form of sarcoidosis.
▪️Risk Factors:
➖The main risk factor for this condition is the presence of tattoos.
➖Certain colors of tattoo inks have been implicated in reports, however tattoo inks are unregulated and therefore the composition of tattoo inks is not standardized.
➖For yet unknown reasons, patients who present with tattoo associated uveitis tend to be younger and more likely to have black tattoos as opposed to colored.
▪️Physical examination:
➖If patients report the presence of tattoos, it is prudent to examine the tattoos for signs of inflammation.
➖A complete ophthalmic examination including dilated fundus examination is warranted to look for evidence of all forms of uveitis - anterior, intermediate, posterior and panuveitis.
▪️Signs:
➖Signs of tattoo-associated uveitis vary depending on the type of uveitis present.
➖In general, tattoos may present with typical signs of inflammation including erythema, edema, induration, pain, warmth, or desquamation.
➖Ocular signs may include conjunctival or scleral injection, tenderness, anterior chamber cell and flare, large keratic precipitates including granulomatous precipitates, posterior synechiae, increased or decreased intraocular pressure, vitreous cell, snowballs or snowbanks, vasculitis, and choroiditis including choroidal granulomas.
▪️Symptoms:
➖Symptoms of uveitis may include pain, redness, sensitivity to light, floaters, and decreased visual acuity.
➖Uveitis and the reaction to the tattoo should occur simultaneously and the symptoms are generally present within the first year after tattooing.
▪️Clinical diagnosis:
➖The diagnosis of tattoo-associated uveitis is based on the presence of both tattoos (especially inflamed tattoos) and uveitis.
➖Diagnosis also generally requires the exclusion of other potential etiologies, especially sarcoidosis.
▪️Photo: Image showing anterior segment with posterior synechiae, flare, and pigment on lens in a Panuveitis patient with Tattoo Associated Granulomatous Uveitis (TAGU).
Credit: www.eyewiki.aao.org
☑️☑️ AT A GLANCE:
* All patients with uveitis should be asked whether they have any tattoos, and all tattoos should be thoroughly examined for any signs of inflammation.
* Coexisting inflammation of the eye and tattooed skin is a hallmark sign of tattoo-associated uveitis, especially if there is no systemic etiology.
* Tattoo-associated uveitis is a rare, late sequela of tattooing that is not completely understood.
* Onset of uveitis typically occurs 6 months or more after tattooing.
* Tattoo ink may serve as an antigenic trigger for the development of granulomas in patients susceptible to sarcoidosis.
* Tattoo-associated uveitis may be associated with systemic sarcoidosis or may represent a delayed hypersensitivity reaction.
* Management options include local steroids, systemic prednisone, steroid-sparing agents, and excision of tattooed skin.
