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Aleksandra Sadowska is 22 years old and dreamed of a career in show business. The gateway to the great world was supposed to be an eyeball tattoo. And it worked, because all of Poland talked about it. Due to the mistake of the tattoo artist, the girl lost her sight in one eye, and in the other one she will most likely be saved. When the case saw the light of day, Alexandra was hit with a wave of criticism and hatred. Internet users pointed out her mindless imitation of one of the Polish rappers, stupidity and a complete lack of imagination. We talk to prof. Jerzy Szaflik, an ophthalmologist from the Eye Microsurgery Center “Laser”, who decided to help the girl recover.
How is Mrs. Aleksandra?
Prof. Jerzy Szaflik, ophthalmologist: She is cared for, complies with and responds to treatment, which is very good news. And mentally – it’s better now and is aware of what happened.
This is the first such case in your career?
Yes. From such extremely difficult cases, I remember a patient who stained herself with a copy pencil. While sharpening, the filing fell into her eye and stuck under the conjunctiva. Much more often I meet people with burns, e.g. with boiling water or caustic substances. Very often, when we do something, the eyes are in the forefront of the “shot” and it is not difficult to damage them, but all these situations are unfortunate accidents. Because someone worked without protection or goggles. This is the first time I encounter a situation where someone consciously puts himself in danger.
Has Aleksandra had any vision problems before?
As far as I know and examined, she had only myopia, the so-called school, i.e. below two diopters.
What exactly happened?
Aleksandra underwent the procedure of eyeball tattooing, which is quite rash action, but she was convinced that it was nothing wrong and everything would be as it should be. Unfortunately, it was not the case. It has been badly stocked, this procedure has been carried out in an absolutely wrong manner, if at all it can be said that such a procedure can be performed, no less a mistake has been made. As far as I know, about 40 such tattoos were made in Poland, but only Aleksandra was involved in such scandalous behavior.
What error are we talking about?
The dye in the form of tattoo ink was applied inside the eyeball, this is completely absurd behavior, because the goal was to make it white in our eyes, i.e. the protein conjunctiva turned black. It would be enough to give this preparation very shallow. Too much of it has been introduced.
Our eyes consist of several layers. The first is the conjunctiva, then there is a thicker vascular layer, then the sclera. It is this part of the eyeball that forms the shape of the eye, protects it, and the muscles that move the eye adhere to it. Then we have the choroid, the retina, the optic nerve, and the lens. The person performing this procedure was supposed to inject this dye under the conjunctiva. Even a small amount of ink would turn it black. Unfortunately, the person who made the tattoo pierced the eyeball and sclera. In this way, the dye got inside the eye and caused its destruction.
As a consequence, the patient stopped seeing. Aleksandra informed the tattoo artist during the application that she had stopped seeing, but he assured her that it was only temporary and the vision would return. Relieved, she agreed to repeat the procedure also in the other eye. Fortunately, the puncture in the left eye was shallower, but too much ink was put in. Then the patient was sent home convinced that the problems were temporary and that her eyesight would return on its own.
But it didn’t.
Yes, there were complications. When the patient was admitted to the hospital in Wrocław, because she could no longer withstand the pressure, pain and photophobia, she finally received professional help. The necessary procedures were performed, but the possibilities of saving this eye were very limited. What could be done was done. The pressure was lowered because she was in terrible pain, some of the foreign body in the form of ink was removed, it was rinsed from the inside of her eye. The procedure caused the eye to develop glaucoma, cataracts and adhesions.
Does the patient have a chance to regain vision in the right eye? And what’s next with the left?
The right eye has lost the ability to see and modern ophthalmology is unable to remedy it. It does not need to be removed temporarily, but it must be treated and taken care not to deteriorate. In addition, the procedure damaged the cornea and drastically impaired tear secretion.
Aleksandra also lost feeling in her right eye, it can be touched, and the patient will not feel anything anyway. In a word, the worst happened.
As for the left eye, the situation is more complex. In fact, the patient can see, the ink is quite deep under the conjunctiva, but luckily it did not reach the sclera. The conjunctival vessels were overgrown. The so-called productive changes and the optic nerve was damaged, which proves that the toxemia, i.e. poisoning the eye with toxins, was high.
At the same time, changes in the lens begin to occur. Her nucleus becomes harder and harder, and the lens begins to cloudy, suggesting that the eye is developing a cataract. How this process will proceed is unknown.
How does Mrs. Aleksandra’s treatment look like?
We are currently using topical treatment. Aleksandra uses, among others special drops that replace tears. The patient has undergone her first examinations and is under observation. In mid-February, we meet again for the next research, which will be crucial and will indicate the further direction of the treatment. We will evaluate the optic nerve and see if the information flow from the eye to the brain is normal. This is called electrophysiological studies. In addition, we will perform functional tests, i.e. assess the field of view. We know that the nerve in the left eye is also damaged, but the extent of the damage is not yet known to us and we will determine it.
Since the cornea is also damaged and the impaired production of tears may become ulcerated, we will want to analyze them both quantitatively and quantitatively. We have a device that allows you to carry out such tests very quickly and accurately. We also use its help in patients with dry eye syndrome.
Does he still have a chance to regain his sight?
Right eye blindness is irreversible. The left eye is in danger of worsening, but I think we should be able to help her and keep her eyesight with the present possibilities. But only further research will provide certainty. Therefore, in my opinion, the safest thing at the moment is to simply observe the patient. The dye most likely caused only local damage, there is no risk that it will spread through the body along with the blood. But even if we manage to stabilize everything, Aleksandra will have to be under the constant care of a doctor all the time, most likely for the rest of her life.
If she went to the doctor right away, would she have a better chance?
Probably so. Although I suppose the right eye could not have been saved anyway, perhaps these processes would have been different. Perhaps more could be done, unfortunately she applied when it was really bad.
However, it should be emphasized that the doctors in Wrocław did everything that could be done. When Aleksandra, on May 19, almost three weeks after getting the tattoo, she found herself in the ER, she had little vision in her right eye. Although the doctors managed to control the glaucoma, lowered the blood pressure, and there was some improvement, it was only temporary because the damage was too great.
The toxic effects of the dye had been going on for some time and had caused serious damage. Despite the fact that, after analyzing the composition, we know that the preparation is relatively safe, the fact where and how much it was given, and a lot of it was given, raises our concerns. We are afraid that its toxic effects will worsen.
Theoretically, it can be removed by cutting out the changed tissue fragments, and in their place a material taken from the oral cavity, eg from the inside of the cheeks, can be ‘inserted’. Unfortunately, such treatments are very complicated and involve a lot of risk.
When the first information about Ms. Aleksandra and that she had an eyeball tattoo appeared in the media, a wave of criticism fell on her. In your opinion rightly so?
It was certainly not a wise decision, but I do not condemn it. She went to a person who she thought knew what she was doing and knew what she was doing. Unfortunately, it was not the case. The story of Mrs. Aleksandra should be a warning to anyone, regardless of age, who thinks about getting such a tattoo. The eye is an extremely delicate organ with an extremely complex structure. We don’t realize that the eye is connected to the brain. Information «downloaded» by the eye goes there. Therefore, any interference is very dangerous and may have serious consequences.
Although this is a dangerous practice, similar tattoos were once done.
In the past, a tattoo was performed on a cornea that was diseased. It was tattooed black. But it was done rationally, for a specific purpose, which is cosmetic. A small amount of the preparation was used and under control, so that the eye looked natural and did not show symptoms of the disease. Today it is not done anymore and such treatments are considered absurd. Currently, cosmetic ophthalmology has much more possibilities. When there is such a need, part of the eyeball is removed, an implant is inserted, and then a cap is made, which looks identical to a healthy eye.
Is this solution also taken into account in the case of Ms Aleksandra?
We will keep this right blind eye, we will check that the dye does not become toxic to the body. In my opinion – at the moment – there are no indications for surgery and there is no need to touch it. The left eye is under control. I am convinced that it can be kept as it is now, but this will only be shown by further research.