Doctors are reporting what they believe is the first case of a corneal dellen caused by pigment aggregation from conjunctival tattooing.

Unusually, the corneal defect manifested eight years after the initial tattoo procedure, say clinicians from the Moorfields Eye Hospital in London.

Their 30-something patient, who denied using contact lenses, had presented to the ophthalmology emergency clinic with increasing ocular irritation lasting for a year.

“Of note, the patient recalled their symptoms began after swimming in the sea while on holiday in the Mediterranean,” the authors wrote in BMJ Case Reports.