J Korean Ophthalmol Soc.  2020 Feb;61(2):146-152. 10.3341/jkos.2020.61.2.146.

The Effect of Eyeliner Tattoo on Meibomian Gland Dysfunction and the Ocular Surface

• Yoon J
• Kim AY
• Jun RM
• Han KE

• KMID: 2470736
• DOI: http://doi.org/10.3341/jkos.2020.61.2.146

Abstract

PURPOSE
To determine whether eyeliner tattoo affects the meibomian gland (MG) and ocular surface.
METHODS
The medical charts of an eyeliner tattoo group (16 eyes of 8 patients) and a control group (16 eyes of 18 patients) were retrospectively reviewed. The ocular surface disease index questionnaire, ocular surface staining score, tear film break-up time (TBUT), upper eyelid abnormality, meibum expressibility and quality, and MG loss and tear film lipid layer thickness (LLT) which measured with LipiView® (TearScience, Morrisville, NC, USA) were compared. In the tattoo group, the correlation between the distance from the MG orifice to the tattoo pigment and other indices were analyzed.
RESULTS
Compared to controls, the tattoo group had a significantly higher ocular surface disease index (p = 0.002), shorter TBUT (p < 0.001), higher vessel engorgement of the upper lid (p = 0.016), poorer meibum expressibility and quality (p = 0.006 and p < 0.001, respectively), higher MG loss (p < 0.001), and thinner LLT (p = 0.024). In the tattoo group, the closer the tattoo was to the MG orifice, the more the upper lid vessel was engorged and the more MG loss occurred (r(s) = −0.560, p = 0.024; r(s) = −0.563, p = 0.023, respectively), and a thinner LLT was observed (r(s) = 0.567, p = 0.022).
CONCLUSIONS
Eyeliner tattoos may be related to changes in the lid margin, loss of the MG, and thinning of the LLT.

Keyword

Dry eye syndrome; Eyeliner tattoo; Meibomian gland; Tear film lipid layer thickness

MeSH Terms

Dry Eye Syndromes
Eyelids
Meibomian Glands*
Retrospective Studies
Tears

Figure

• 

  Figure 1 The area of the central two-thirds on upper tarsal conjunctiva, in which meibomian glands were best visible, was selected through drag and drop with mouse (A). Then, the area of meibomian gland dropout area within the aforementioned area was selected in the same manner (B). The ratio of the two area was calculated.

• 

  Figure 2 Distance between the tattoo pigment and the meibomian gland orifice was scored and was recorded as the tattoo score (mm). In each right (A) and left eye (B), the blue arrows on the top indicates tattoo pigment, and the yellow arrows at the bottom indicates meibomian gland orifice. In this case, the distance or tattoo score was measured as 1.0 mm in each eye.

• 

  Figure 3 Meibomian gland (MG) loss of eyeliner tattoo group and tear film lipid layer thickness (LLT) of eyeliner tattoo group. (A) MG loss was significantly correlated with the tattoo score (rs = −0.563, p = 0.023; Spearman correlation test). (B) LLT was significantly correlated with the tattoo score (rs = 0.567, p = 0.022; Spearman correlation test).

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