This patient had a history of body modification, including scleral tattooing. 

Scleral tattooing is a cosmetic / body modification procedure, whereby ink is injected into the subconjunctival space, resulting in pigmentation of the sclera. This procedure is not typically performed by medical professionals and is relatively uncommon. A handful of reports exist regarding complications of this procedure, and as imaging is usually unnecessary for diagnosis there are few case reports containing CT images of this procedure.

This case demonstrates a patient who had no acute pathology, but incidental scleral hyperdensities, due to previous successful scleral tattooing. The materials within the ink itself likely result in the high density and a similar appearance can be seen in a Canadian case series on an accidental globe penetration after attempted self-scleral tattooing ¹.

Knowledge of this procedure and imaging appearances of other cosmetic eye procedures can help define pathological mimics within the orbit ².