A Woman Started Losing Her Sight Because of a Tattoo She Got Years Ago on Her Back. She’s Not Alone

Nelize Pretorius first noticed the blur in one eye, then the other. Doctors thought it was conjunctivitis. Tests said otherwise.

“I could hardly see,” she recalled. “I was losing my vision and nobody was able to tell me why,” she told ABC.

The source of the problem was not in her eyes at all. It was a tattoo on her back, inked years earlier.

Researchers in Australia have now documented 40 cases of a condition called tattoo-associated uveitis, an inflammatory disease that can threaten sight. The complication—once considered exceedingly rare—may be emerging more often than doctors realized.

Uveitis occurs when the immune system inflames the uvea, the eye’s middle layer. Symptoms can include blurred vision, pain, redness, and sensitivity to light. Without treatment, the inflammation may progress to glaucoma or permanent vision loss.

Tattoo-associated uveitis appears to begin far from the eye. Scientists suspect an immune reaction to tattoo pigments may inadvertently target eye tissue, though the mechanism remains unclear.

Ophthalmologist Josephine Richards described the mystery plainly: “We do not know why the eye gets caught in the crossfire,” she said. “There is something about the immune reaction that targets the eye.”

A Rare Condition Coming into View

Pretorius’s case is no longer isolated. Across Australia, specialists began noticing similar patients—often young and tattooed—arriving with unexplained eye inflammation.

“I only became aware of it about four or five years ago, and then once I was aware of it, I had all these patients all of a sudden,” Richards said.

When ophthalmologists compared notes at a professional meeting, the pattern became difficult to ignore. The new study confirmed dozens of cases nationwide, potentially doubling the number described in the scientific literature since 2010.

Most patients required long-term treatment that suppresses the immune system. Only three patients maintained normal vision throughout treatment, while others experienced varying degrees of visual impairment. Some could not taper off medication, an outcome that troubles clinicians accustomed to seeing autoimmune eye disease settle over time.

“What really worries us is that we’re just not managing to get these people off the drugs,” Richards said. “Usually with an immune disease, we treat for two years and then slowly wind back treatment and hope that the person’s going to be OK off the treatment. But mostly we’re not managing to wind back the treatment.”

The inks themselves are the prime suspects. Black pigment appeared most often among affected patients, though red and pink inks surfaced in isolated cases. Symptoms typically emerged one to two years after tattooing—but in one striking instance, more than three decades later. Moreover, because many tattoos were applied overseas, tracing the exact chemical makeup of the dyes is difficult.

Despite the alarming stories, experts stress that the overall risk remains small. Surveys suggest roughly 20 to 30% of Australians have tattoos, meaning millions experience no such complications. Still, the clustering of cases raises new questions about who might be vulnerable and why.

Immunity Clues

Some answers may lie in diseases that resemble tattoo-associated uveitis. Inflamed tattoos can look strikingly similar to sarcoidosis, an inflammatory disorder in which immune cells form clusters in organs such as the lungs and skin.

“You can take a biopsy of an inflamed tattoo, and it looks almost the same as what you’d see in the chest with sarcoidosis,” Richards explained.

Genetic susceptibility could shape how an individual’s immune system reacts to tattoo pigments. The microbiome may also influence the response, though evidence remains preliminary.

For patients, the consequences are immediate and personal. Pretorius has spent thousands of dollars on treatment and continues to rely on steroid eye drops.

“You get a tattoo, and you think the risk is that you might regret it later in life,” she said. “[The real risk is] you could potentially lose your vision.”

Yet neither patients nor doctors expect tattoos to disappear. “So many people get tattooed, and I feel like it would be very hard to stop people from doing it,” Richards said.

Instead, researchers hope to make tattoos safer by identifying problematic pigments and improving awareness among clinicians. Early diagnosis can prevent irreversible damage, especially when unexplained uveitis appears in someone with tattoos.

Pretorius considers herself fortunate. “There’s a few people [with tattoo-associated uveitis] that lost their vision permanently, so relatively speaking I came off pretty good,” she said.

As tattooing becomes increasingly routine, the study identifies a rare pathway by which immune responses to skin pigments can threaten vision. Early detection and deeper study of the mechanisms involved remain essential to preventing avoidable harm.

The findings appeared in the journal Clinical and Experimental Ophthalmology.