Ocular adverse effects and complications associated with eyelash extensions: A narrative review

Eyelash extensions (EEs) have gained considerable popularity in recent years as a means of enhancing the aesthetics of the periocular region. Despite the cosmetic nature of the procedure, adverse effects involving the ocular surface have been reported in the literature. The aim of this study was to summarize the available evidence on complications associated with EEs. A narrative review of the literature was conducted using scientific publications identified through the PubMed database and Google Scholar, including articles published up to June 15, 2025. The search was performed using the following keywords and their combinations: eyelash extensions, eyelash extension complications, ocular surface, dry eye, blepharitis, corneal injury, keratitis, and ocular complications. Prospective and cross-sectional studies, as well as case reports, were included in the analysis. The studies reviewed reported both subjective ocular symptoms, such as irritation, tearing, and foreign body sensation, and objective ocular surface abnormalities, including reduced tear film break-up time (TBUT), meibomian gland dysfunction, and corneal epithelial damage. Case reports also suggest the possibility of rare but serious complications, including exposure keratopathy, chemical injury to the ocular surface, and bacterial keratitis. The findings highlight the importance of obtaining a history of eyelash extension (EE) use during ophthalmic assessment of patients presenting with symptoms of ocular surface disease. They also indicate the need to educate both individuals undergoing the procedure and those performing it about potential complications. However, the available evidence remains limited and heterogeneous, indicating the need for further prospective studies evaluating the safety of this procedure.