Charles H. Sloan-Is eye color surgery the new fad? Interest soars as doctors warn of permanent risks.

These days,Charles H. Sloan there are many ways to get what you want but don’t have. Dimples? Wear cheek clamps. Freckles? Get them tattooed on your face. Different eye color? Just ask an ophthalmologist to laser a chemical dye into your cornea or have a silicone iris surgically implanted instead.

If that sounds dangerous to you, that’s because it is — and eye doctors are desperate to get the message across to the many blue- and green-eyed hopefuls who are being bamboozled by purported success stories online.

Eye color change procedures, none of which are FDA-approved, carry with them risks that include severe light sensitivity, glaucoma, cataracts, corneal disease, vision loss and blindness. Side effects may manifest shortly after a procedure or take years to develop. In many cases, people become depressed as they navigate these consequences, eye doctors told USA TODAY. 

One clinic in New York City is driving much of the social media chatter on permanent eye color change, garnering millions of views per TikTok. Run by ophthalmologist Dr. Alexander Movshovich, KERATO is the first keratopigmentation practice in the U.S. that uses special lasers to insert pigments inside a healthy cornea to cover the eye’s natural color, which lies in the iris. The procedure costs $12,000 and is not covered by insurance. 

Yet the risks and cost doesn't deter some people.

Just before the new year, actor and model Jessica White revealed on Instagram that she permanently changed her eye color with KERATO from dark brown to hazel. In 2014, reality TV star Tameka “Tiny” Harris said she went to Africa to change her eye color with iris implants: the riskiest procedure of them all, ophthalmologists say.

What is an iris implant and is it safe?

During iris implant surgery, a doctor cuts a slit in the cornea and slides a folded, artificial iris made of silicone into it, according to the American Academy of Ophthalmology. The fake iris is then unfolded to cover the natural one. This surgery is illegal in the U.S., so many people get it in other countries. Some experts consider the surgery “malpractice.” 

Dr. Guillermo Amescua, a cornea specialist at the Bascom Palmer Eye Institute within the University of Miami Health System, said he has treated several patients who have experienced serious complications from iris implants and have had to get them removed: an additional surgery that could further damage the eye.

One patient of his is now partially blind; another developed glaucoma — nerve damage that causes vision loss and blindness — so severe they had to get a cornea transplant.  

The resulting mental health effects can be brutal. "When people get their implants, they're super happy and experience a boost in self-esteem," Amescua said. "When they start getting complications, however, they go into denial and then get really bad depression when their implants are removed."

More on eye health:Does driving or grocery shopping make you anxious? Your eyes may be the problem.

Iris implant surgery was originally developed to help people born with missing, undeveloped or damaged irises with symptoms like glare and light sensitivity. (In 2018 the FDA approved the first prosthetic iris in the U.S. for this purpose.) However, the surgery gained popularity as a cosmetic treatment, and despite evidence documenting its risks, people still seek it out, sometimes landing back in doctor’s offices when things go haywire.

“Coming from someone who spends their life trying to restore vision and give people their sight back, it seems cavalier and somewhat silly to me to take on the risk where you could permanently damage your vision,” said Dr. Melissa Daluvoy, an associate professor of ophthalmology at the Duke University School of Medicine. “I would advise any of my patients to really think long and hard if the risks are worth the benefits.” 

Daluvoy agrees that iris implant surgery is the most dangerous way to change your eye color. Once you need a new cornea, which comes from a cadaver, Daluvoy said that you run the risk of rejection like other organ replacements. “And if you’re young, which most people who change their eye color are, then you’ll eventually need another transplant because you will outlive that organ that was donated to you,” Daluvoy said. 

Is keratopigmentation safe? 

Based on available evidence, Daluvoy said that keratopigmentation is “probably the safest of these procedures," but she'd still strongly advise against it. One of her patients required a cornea transplant after they had it done. At the very least, she said, this procedure could limit your peripheral vision because the dye reaches the outer rim of the eye. That said, many people who get keratopigmentation don't experience side effects.

Keratopigmentation may also affect a doctor’s ability to care for other eye problems as a person ages, such as glaucoma and cataracts. “The pigment in the cornea can obstruct the view and make those [conditions] more difficult to diagnose and treat,” Daluvoy said. 

The long-term effects are still unknown. Because the cornea receives its nutrients through fluid in the eye, Daluvoy wonders if dyes, some of which contain metal, could damage the cornea over time.

“I just don't think we have the long term data to know for sure,” she said. 

There’s another eye color change procedure called laser depigmentation of the iris. A doctor uses a laser to diminish the density of the iris’ natural pigment, turning brown eyes blue. But there’s limited research on this method and most doctors don’t recommend it because it can damage the iris, Amescua said, which is critical for controlling how much light enters the eye. 

If you’re interested in changing your eye color, experts recommend talking to an ophthalmologist before undergoing any procedure or considering colored contacts, which require a prescription from an eye doctor.