Before getting a piercing, most people put some thought into where they’d like to get pierced. There are lots of options, as it’s possible to add jewelry to virtually any area of skin on your body — even your teeth.

But did you know it’s also possible to pierce your eyes?

Eyeball piercings are much less common than other body piercings, but they have gained popularity since they were invented at the Netherlands Institute for Innovative Ocular Surgery in the early 2000s.

Eyeball piercings aren’t performed the same way as traditional body piercings, which are done with needles or piercing guns.

Eyeball piercings, technically called extraocular implants, involve surgically implanting jewelry just below the clear surface of the white of your eye.

It’s important to note that this is a cosmetic procedure that comes with serious risks. Most eye doctors will not perform this type of surgery and highly discourage it.

An eyeball piercing can be a small shape, like a heart, star, or gemstone, in the white of your eye. The jewelry is very small, just a few millimeters wide, and is made from a platinum alloy.

The procedure is performed by eye surgeons who are comfortable working with eyeball jewelry, and who have the proper tools to implant it.

A similar but more extensive procedure is called an intraocular implant. During this surgery, an entire artificial iris, which is the colored part of your eye, is inserted below the top clear layer of the eye on top of your natural iris. Your eyes will be a different color after the procedure.

This procedure was originally developed to change the eye color of people with irises that didn’t develop normally, or who had injuries that damaged their eyes.

Today, however, there are more people seeking intraocular implants for cosmetic reasons.

Very few eye surgeons offer eyeball piercings. In some places, it’s not legal to perform these procedures because of the high level of risk that’s involved.

What’s more, not all eye surgeons are comfortable with this tricky surgery, even if it’s legal where they practice. The procedure requires exact precision and specialized tools to avoid what are sometimes very serious complications.

Here’s how the procedure generally goes:

  1. You undergo preoperative testing to check that your eye health and function is completely normal and thus fit for surgery.
  2. You select the type of jewelry and placement you’d like.
  3. An anesthetic will be injected into both of your eyes to numb them so you don’t feel pain.
  4. You may be offered another type of anesthetic, called nitrous oxide (also called laughing gas).
  5. You may be offered a sedative drug, such as Valium.
  6. Your eyelids will be held open with a special device called a speculum so they don’t move during the procedure.
  7. Using a tiny blade, your surgeon makes a small cut between the white of your eye (the sclera) and the transparent layer that coats it (the conjunctiva) to create a pocket.
  8. The jewelry is put inside the new pocket in your eye.

Because the incision for the jewelry is so small, there are no stitches or sealing required to help heal your eye.

Eyeball piercings usually cost around $3,000.

It’s true that some parts of the body are more painful to pierce than others. Reports of pain during extraocular implant procedures are mixed. Some people report a lot of pain, while others report none at all.

This isn’t surprising, because everyone’s level of pain tolerance differs.

Plus, the local anesthetic the surgeon inserts in the eye will somewhat reduce pain. People might also experience some itchiness in their eye for a few days. The piercing typically heals within a few days.

All surgical procedures carry risks.

According to the American Academy of Ophthalmology (AAO), people should avoid eyeball piercings because they don’t have enough safety evidence and come with many risks.

The AAO also notes people should avoid putting anything into the eye that’s not approved to be medically safe by the Food and Drug Administration.

The AAO also warns of various complications, including:

The risk level of a surgery increases when it involves putting a foreign object in your body. Eyes are among the most sensitive parts of the body and naturally try to reject objects that enter them.

For example, even using contact lenses increases your risk for an eye infection. With eyeball piercings, you’re putting a platinum shape into one or both of your eyes.

If you do decide to get an eye piercing or recently got one, here’s how to take care of it.

Some level of discomfort, such as pain or itching, following your eyeball piercing is normal. Your doctor may recommend you take an anti-inflammatory medication to help ease the pain.

Otherwise, take it easy with using your eyes for a few days. When they feel normal again, you can resume your usual activities.

Avoid touching your eyeball piercing, as this can put you at risk for a serious eye infection. It’s important to keep any other foreign objects out of your eye, like contact lenses or dust. Keep your eyes clean.

Your eyeball piercing is a permanent part of your eye. There’s no need to remove or replace it so long as it’s not bothering you.

If you do notice signs of an eye infection, reach out to your doctor right away.

You’ll need to attend several eye exam appointments after you get the piercing to ensure your eye stays healthy.

These follow-up visits help your doctor catch any complications you’re having with your eyeball piercing before they become more serious.

If your eyeball piercing feels very uncomfortable, or if you experience any of the following symptoms, schedule an appointment with your doctor right away:

An eye surgeon can remove your eyeball piercing within minutes if it’s harming your eye. However, some complications of eyeball piercings can cause permanent eye damage.

It’s important to pay attention to how your eye looks and feels following the procedure. And be sure to go to your doctor’s follow-up appointments.

Eyeball piercings are a newer, extreme body art trend. They’re not common due to the high level of risk involved.

If you’re interested in getting an eyeball piercing despite the risks, it’s important to know exactly what the procedure, risks, and aftercare entail.

These permanent eye decorations increase your risk for eye infections and eye tears, which can lead to vision loss or changes, or even permanent blindness.

If you get an eyeball piercing, be sure to follow your eye surgeon’s instructions carefully before and after surgery. Be sure to attend your follow-up appointments, and report any signs of complications right away.