These 3 Procedures Will Change Your Eye Color—But at What Cost?

Beauty standards are ever-evolving, but there is one feature that transcends trends: eye color. Though estimates vary, it is believed that nearly 80% of the world’s population has brown eyes. Genetically, there is a purpose for this. “Skin tone and eye color are often complementary for health reasons—in places where it’s extremely sunny, having that extra pigmentation can be protective,” says Dr. Ashley Brissette, a board-certified ophthalmologist in New York City. “But there’s something about having lighter-colored eyes that people perceive as this ideal beauty standard, and people will go to any length to have them.” 

Most people who want a different eye color dip their toe into the world of blue or green eyes by trying colored contact lenses. They come in a spectrum of shades and are pretty simple to use. But any ophthalmologist will tell you that hygiene is critical to eye health; when you consider that you have to stick your finger in your eye twice a day to use lenses as well as keep them sterile, colored contacts begin to lose their appeal—especially for those who want a color change that lasts.

“In the majority of cases, patients who came to me who had been wearing colored contact lenses said, ‘I’m fed up with putting contact lenses in the morning. I want to see myself in the mirror right away,’” says Dr. Alexander Movshovich, a board-certified ophthalmologist based in New York City. For these individuals, there are actually three different options that can be used to change the color of the eye, but none are FDA approved for cosmetic use—yet—and some could place your ocular health in serious danger. Here, we break down everything you should know about eye color surgery and color-changing eye treatments, including how they work, how much they cost, and what the lasting ramifications could be. 

A quick primer on eye anatomy

Before we get into the three color-changing procedures, you’ll need to understand the anatomy of the eye. The colored part of the eye is known as the iris, which surrounds the pupil, the aperture that adjusts the amount of light coming into the eye. (If you look in the mirror and think of someone you love or dim the room, you’ll notice your pupils get bigger; they’re constantly self-adjusting, to give your eyes what they need to function at their best.) Behind the pupil is the lens, the clear disk that focuses what you’re seeing onto the retina at the back of the eye, where those images are transmitted via electrical signal to the brain, making them recognizable to you.

Covering the entire diameter of the iris (and everything between) is the cornea, clear dome-shaped tissue acting like a windshield for your eye. In addition to refracting light, it protects your eye from dirt, bacteria, and irritation. In this article, we’ll be focusing on these key parts of the eye.

Iris implant surgery

After colored contact lenses, this is perhaps the most well-known color-changing procedure. It’s also the most invasive and most dangerous. The results of iris implant procedures have been making the rounds on TikTok lately, but many people first learned of this procedure back in 2014, when Tameka “Tiny” Harris-Cottle (entertainer and wife of rapper T.I.) underwent this procedure, changing her eyes from dark brown to light gray, revealing on Instagram that she did so with BrightOcular. Her daughter, Zonnique Pullins, also had her eye color changed. This procedure tends to cost around $6,500, not including travel and accommodations; this technique is largely done in Latin America and Africa.

It is alleged (but not confirmed) that BrightOcular originally operated under the name New Color Iris, a now defunct company founded by Panamanian ophthalmologist Alberto Delray Kahn, who invented cosmetic iris implants. He is rumored to be on the lam from local authorities after performing iris implant surgery on his wife, who nearly went blind. The negative outcomes of both BrightOcular and New Color Iris lenses have been written about extensively in journals: this study of a dozen patients who had cosmetic iris implants showed iris abnormalities, intraocular eye pressure, and cataracts. 

Iris implants for cosmetic use are only about 20 years old, but therapeutic ones date back to the 1960s and are medically necessary. “There are conditions that can cause you to be born without an iris or missing some of it,” explains Dr. Diane Hilal-Campo, a board-certified ophthalmologist in Oakland, New Jersey. Coloboma is one, which occurs when not all of the tissue develops in the eye. This can happen in the iris, which can create a keyhole effect (missing child Madeleine McCann is one of the most well-known cases). Aniridia is when most or all of the iris is missing, causing an abnormally large or misshapen pupil. Not only does this cause a patient to be very sensitive to light, but it also can affect clarity of vision, explains Dr. Hilal-Campo. In some cases, cataract surgery can damage the iris, leading to atrophy and, again, affecting light sensitivity and vision. 

Therapeutic artificial iris implants, like those made by Human Optics, are FDA approved. “They’re very well engineered, they look good, they’re [made of] highly textured and specialized material,” explains Dr. Gregg Homer, JSD (PhD), chairman and chief science officer at Strōma Medical Corporation. These implants are custom sized for each patient and stitched into place. Not so with cosmetic implants, which aren’t customized for each eye but rather use average measurements; this can make the final result look jarring in person. Nor are the implants carefully placed: “They make a hole in the cornea, roll up the iris implant, and insert it with an injector tool,” says Dr. Homer. From there, it unfurls, then just the corners are stitched, to hold the implant in place. But most of the time, the implant ends up moving, affecting fluid outflow and increasing pressure within the eye.

“Putting hardware into the eye like that causes a lot of complications,” says Dr. Brissette—and they’re not minor concerns. “We’ve seen complications like glaucoma, which is a blinding disease and can permanently damage your vision, inflammation, cornea degradation, with some people needing a corneal transplant, bleeding within the eye, infections.” Adds Dr. Hilal-Campo, “Surgeons think risk versus benefit. If someone’s eye can’t function [without an implant] because their natural iris is damaged, that’s a reason to risk these things. For cosmetic reasons, these risks aren’t worth it.” Though it isn’t for the faint of heart, you can watch a cosmetic iris implant being removed here by Dr. Stephen Slade; the explantation improved the patient’s vision, inflammation, and intraocular pressure, all of which had been negatively affected by the implant. 

Dr. Brissette, who is a spokesperson for the American Academy of Ophthalmology, says the organization is highly against these implants and that they aren’t FDA approved for a reason—they can trigger severe complications and diseases that can cause permanent vision loss. Despite this, some people still won’t give them up: A handful of patients who have developed glaucoma from iris implants refuse to have them removed. “I can’t imagine losing my vision and being able to do something about it—and then not acting on that,” says Dr. Brissette. “That really speaks to the psychology behind the type of patient who is extremely motivated to go through something like this.” (For what it’s worth, Zonnique Pullins underwent an explantation procedure after experiencing complications from her grayish-blue implants. Harris-Cottle has left her ice-gray implants intact.)

Keratopigmentation

For those who like the look of their colored contact lenses but just want them to last, keratopigmentation—a concept similar to tattooing—may be the best bet. While it was once done mechanically (and not particularly precisely) with a scalpel, today it is performed as an off-label use of an FDA-approved device known as an femtosecond laser. This technology makes tunnels within the stroma, the thickest part of the cornea.

Dr. Movshovich is one of the foremost providers worldwide offering keratopigmentation at his practice, Kerato NYC; he has performed ophthalmologic surgery for more than 35 years but now focuses on this cosmetic procedure due to high demand. “Keratopigmentation is a combination of medicine and art,” he says. He has developed special instruments to improve patient outcomes, in addition to manually adjusting the device to create the channels in a more aesthetically pleasing way. The laser is administered through two tiny slits made in the eye, where the pigment is then deposited. These pigments are mineral-based formulas and have been used for more than 15 years in medical settings throughout Europe. 

Dr. Jorge Alió, an ophthalmologist in Alicante, Spain, is credited with creating this pigmentation technique and has published his findings, inclusive of complications, in multiple journals. This study of his notes that in an evaluation of 234 eyes, less than 13% experienced side effects, with the majority of them being light sensitivity and others experiencing color fade. (Serious complications like those found in patients with iris implants, such as glaucoma, were not found.) Over the years, Dr. Alió has worked to develop new fade-resistant pigments; blue is often the least stable color. “In approximately a year, it can start to fade,” says Dr. Movshovich. “It doesn’t do anything to the eye—no toxicity, no inflammation—it just loses the color. But only blue—others are working perfectly.” 

“Others” can be, quite literally, any color you dream up, whether that’s red, yellow, white, or black. “There’s people who ask me to do rainbow,” says Dr. Movshovich. But most people opt for natural colors—blue, green, gray, and light-brown shades. A natural look is achieved by not just the color selected but the intensity of the pigment. Lower intensity creates a more natural, semitranslucent effect, which improves visibility for any ophthalmologist examining the eye. However, Dr. Movshovich also doesn’t pigment over the entirety of the visible iris. “I leave a clear area of 5.5 millimeters, which corresponds, in the majority of cases, to the dilated pupils during the night,” he says. “Keratopigmentation doesn’t affect your night vision, it doesn’t affect examination for glaucoma or for the retinal exam or for cataract or retinal surgery.”

His keratopigmentation procedure takes about half an hour, after which he places a bandage contact lens into each eye. This reduces any corneal irritation the patient might experience. Typically, once they return to see him the next day, the incisions have healed and the lenses can be removed. Patients use antibiotic eye drops for three weeks post-op to help suppress inflammation and infection, but otherwise, recovery is simple for most. Dr. Movshovich charges $12,000 for this one-and-done procedure. 

Just as iris implants are used to reduce the complications of aniridia or surgical trauma, so too is keratopigmentation. Dr. Paul Dougherty, a board-certified ophthalmologist in Westlake Village, California, does the functional iterations of these procedures but not cosmetic ones, due to concerns about how they could affect future cataract surgeries as well as how they change aesthetically over time. “I had a patient with albinism who had a loss of pigmentation in their irises from cataract surgery and had severe glare; I was able to color-match it with a bluish pigment,” he says. “But over several years, it became splotchy—and cosmetically and functionally, not what it had been.”

It’s worth noting that in addition to iris implants, the American Academy of Ophthalmology has issued a warning on keratopigmentation, citing concerns regarding cornea damage, negative reactions to the dye, and infection, among others. (But just as this procedure is not FDA approved, neither are any forms of tattoos, including body art and permanent makeup like lip blushing—just something to think about.)

Laser depigmentation

The third form of eye-color-changing procedures is laser depigmentation, which is exactly what it sounds like: a laser is used to remove the pigment from the iris, which will reveal a lighter color, regardless of the shade you were born with. This is because eyes are blue in the way that the sky is blue: “What you’re seeing is white light that’s scattered when it hits the stromal fibers, like a prism,” explains Dr. Homer. When light hits a prism (or in this case, the iris), wavelengths reflect and refract, separating into the different colors of the rainbow. Blue has one of the shortest wavelengths, so it is scattered the most, creating the appearance of a blue eye. We can see this effect in lighter eyes because they have the least amount of melanin—dark eyes have more melanin, which absorbs more light and reflects less. 

Dr. Homer filed for his first patents on laser eye-color change in early 2001; since then, doctors worldwide have popped up, offering laser depigmentation using Nd:YAG lasers—the same ones used for laser hair removal or lightening sunspots. But as you can imagine, this is extremely dangerous. These lasers are not designed for this use and are manipulated by the provider to defocus the laser and adjust the energy—as they go along—to apply the laser evenly across the iris. This procedure takes at least an hour and an average of 20 rounds of treatments to achieve the desired effect. Beyond the inconvenience, there are huge risks to your eyes with this procedure, both cosmetically (a lack of controlled heat can leave you with polka-dotted irises) and functionally (if the beam is fired into your pupil, it could damage your retina and leave you blind). 

There’s also the concern of free-floating pigment. When the pigment cells of the iris are blasted with too much energy, they’re ablated—popped open—letting free melanin float into the area between the cornea and the iris. “When pigment is released, it clogs up the filtering mechanism of the eye and can cause glaucoma, which can increase pressure and cause irreversible vision loss,” warns Dr. Diane Hilal-Campo. 

For more than 14 years, Dr. Homer and his team at Strōma have been working to raise the bar, collaborating with the American National Standards Institute, NASA-affiliated technology companies, and ophthalmologists worldwide as well as obtaining countless patents to create a new form of laser depigmentation, designed to mitigate risk and produce predictable results. He and his team are currently in discussions with the FDA regarding U.S. regulatory approval to begin clinical studies of his own system for laser depigmentation through Strōma. If it receives approval, it will be the first laser device designed for safe and effective eye-color change.

The Strōma procedure would differ from other iterations of laser depigmentation in that the laser has been designed specifically for eye-color change and is therefore much more precise. It’s designed to autofocus the laser beam at the iris using computer tracking and treatment, with a high-divergence beam angle designed to defocus the beam at the back of the eye. Instead of using an energy level that would ablate pigment cells, the Strōma laser is intended to deliver a much lower one that denatures them. You’ve seen this process in action if you’ve ever gotten IPL for dark spots. “Denatured pigment cells release a cytokine protein signal, which recruits macrophages,” says Dr. Homer. Macrophages play a critical role in your immune system—they eliminate damaged cells. Instead of releasing free melanin, denatured pigment cells are “eaten” by macrophages and removed through the bloodstream, which should prevent them from getting stuck in the eye and causing an increase in pressure. 

“We’re actually seeing a lowering of intractable pressure, which is fascinating to me,” says Dr. Dougherty, who became an investor in Strōma after witnessing the technology firsthand in Costa Rica, where it is being administered by the former president of the Central American Ophthalmology Society, Dr. Claudio Orlich. While he admits he was initially skeptical, he became a believer. Dr. Dougherty has been part of several U.S. Senate FDA studies and has helped develop forms of technology that are used today in vision-correction surgery. “I have a great sense of the development process and the emphasis that the FDA puts on safety,” he says. “All the fail-safe mechanisms that Dr. Homer and the crew at Strōma have put in place are amazing—and particularly, compared to the other technologies that are out there, it’s night and day. The bottom line is, it works and does not cause problems.”

Though Strōma is still in its clinical testing phase and not approved by the FDA, this phase has indicated what the pretreatment consultation and procedure are likely to look like. With the company’s proprietary software, your provider would generate an image of your face with your predicted post-op eye color. “It’s important in aesthetics to manage expectations, and part of that is being able to show the patient their predicted outcome as realistically as possible,” says Dr. Homer. Though the software testing suggests a high probability of accuracy already, it should continue to get more accurate as the database of before and after images grows. After the consultation, a patient would lie down for their treatment, which in clinical trials took about 30 seconds per eye. The procedure is designed to require multiple treatments for the best results. The majority of clinical patients were satisfied with their new eye color after three or four rounds. Strōma anticipates that U.S. providers would offer an initial package of up to five treatments for $5,000 to $7,000. Remember that the price of aesthetic procedures always varies depending on the provider, the location, the demand, and other factors. 

As is the case with any cosmetic treatment, changing your eye color undoubtedly comes with potential risks and side effects. “Nothing motivates people more than wanting to look different,” says Dr. Brissette. “At the end of the day, our health and our vision are our most precious resources.” But for those who have dreamt of lighter eyes their whole lives, the benefits may very well outweigh the risks, especially as technology and technique continue to advance.