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August 21, 2024/Health Conditions/Eye Care

The Dangers of Eye Color-Change Surgery

Cosmetic procedures such as iris implants and corneal tattooing bring a risk of vision loss

Up close eyes of different colors

What color are your eyes? The answer for some appears to be “the wrong color” — and they want to do something about it.

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Interest in surgeries to change eye color is surging thanks to trending social media posts showing dramatic transformations. Goodbye, boring brown eyes! Hello, stunning aquamarine peepers!

But before taking out a color wheel to find your perfect hue, know that you may get more than just a new look from these procedures. You may also end up with vision problems.

We talked to ophthalmologist Nicole Bajic, MD, about the risks.

Is eye color-change surgery safe?

It’s safe to say eye color-changing procedures raise some concerns.

The American Academy of Ophthalmology (AAO) issued a warning in 2024 about the dangers of surgery to change the color of your eyes. The call for caution emphasized that the procedures bring a risk of vision loss and other complications.

“We do not recommend these sorts of procedures,” stresses Dr. Bajic. “A lot can go wrong for something done purely for cosmetic reasons. It’s not worth the risk.”

No eye color-change procedure has been approved by the U.S. Food and Drug Administration (FDA), she adds. Some medical practices in the United States offer the service, however, as an “off-label” option outside of sanctioned practice.

Eye color-change surgery is also performed in other countries around the world.

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Procedures to change eye color

Different procedures take different approaches to changing eye color. Let’s look at the three most common options and the risks of each.

Iris implant surgery

The color of your peepers is determined by your iris, a layered ring of muscle tissue around the pupil in each of your eyes. Change your iris and you change your eye color.

During an iris implant, an artificial iris made of silicone is placed over your existing iris to give your eyes a new shade. The implant is inserted through a slit cut into your eye near your cornea.

“I have yet to hear of someone doing well from one of these cosmetic implants,” states Dr. Bajic.

Risks of the procedure include:

  • Glaucoma from elevated pressure inside the eye. This can be potentially blinding.
  • Infection and inflammation that can cause pain and blurred vision.
  • Cataracts.
  • Sensitivity to light.
  • Damage to the cornea.

The FDA has approved iris implants for medical reasons, such as a damaged or missing iris. That procedure comes with the same risks noted. But the difference is the surgery is done to improve compromised vision — not for prettier eyes.

Laser pigmentation removal

A pigment called melanin gives the iris color. The more melanin you have, the darker your eyes will be, explains Dr. Bajic. People with brown eyes have lots of melanin. People with blue eyes have less.

Laser pigmentation removal can change the appearance of eyes by releasing layers of melanin to reveal lighter colors beneath.

“But one of the big risks in releasing all of that pigment is that it can clog up drains inside the eye,” explains Dr. Bajic. “That can lead to a buildup of pressure that can cause glaucoma and vision loss.”

There are also no guarantees on your final eye color, as the resulting shade depends on the remaining levels of melanin.

Keratopigmentation

Much of the social media buzz around eye color changing involves keratopigmentation, also known as corneal tattooing.

In this procedure, a needle or laser is used to create channels in the cornea, shares Dr. Bajic. Pigment is then injected into this space to give your eyes a new color. (In essence, you’re changing the color above your iris.)

Risks of the surgery include:

  • Corneal damage that can cause impaired vision or even vision loss.
  • An adverse reaction to the dye, resulting in uveitis and other forms of inflammation. Leakage of the dye also has been an issue.
  • Infection resulting in scarring to the cornea.
  • Lifelong difficulty examining into the eyes.

Is there a safe way to change eye color?

There is a way to change the color of your eyes WITHOUT resorting to surgery. Colored contact lenses can give your peepers a makeover without the use of any lasers, incisions or dye injections.

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But be wary of “costume” or novelty contacts, warns Dr. Bajic. These nonprescription contact lenses can scratch your cornea and infect your eye.

Talk to your eye doctor if you’re interested in colored contacts to get fitted for a pair, then wear them as prescribed. “Getting colored contacts can give you the look you want without putting your eye health at risk,” she reinforces.

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