There have been no reports, to our knowledge, of a clinical presentation of ocular pigmentation secondary to the use of oral tetracycline only. Tetracycline hydrochloride is not a well recognised cause of ocular pigmentary changes, but has been reported to cause pigmentation of teeth and nails.¹ Of all the tetracyclines, minocycline (a second generation drug) is most often associated with the adverse effect of pigmentation.¹ There have been several case reports of minocycline induced scleral pigmentation.^2–6 Ocular pigmentary changes reportedly caused by tetracycline have been noted in association with use of minocycline.^7,8 Both patients in these case reports had had tetracycline/minocycline therapy for more than 10 years for acne vulgaris and had their deposition localised within the tarsal conjunctiva.⁷ …