Tears are naturally clear, watery fluids that constantly bathe the eyes, providing lubrication and washing away debris. The tear film is a complex mix of water, oil, and mucus, containing proteins and minerals that nourish the eye and fight infection. While tears are generally transparent, a yellow tint or discharge signals a change in composition. This discoloration indicates an underlying issue, ranging from a localized eye infection to a systemic health problem.
Localized Causes of Tear Discoloration
The most common reason for tears to appear yellow is the presence of pus, a collection of dead immune cells, bacteria, or viruses. This discharge is a byproduct of the body’s localized fight against infection in the eye or its surrounding structures. The yellow or yellowish-green color is frequently associated with bacterial infections, such as bacterial conjunctivitis (pink eye).
In bacterial conjunctivitis, white blood cells are sent to the infected area. The resulting debris mixes with tears and mucus, creating thick, sticky discharge that can cause eyelids to crust over upon waking.
A blocked tear duct, a condition called dacryocystitis, also leads to yellow tear discoloration because tears cannot drain normally. When the drainage system is obstructed, tears pool in the lacrimal sac, allowing bacteria to multiply and cause infection. Localized inflammation of the eyelids, such as a stye or blepharitis, can also produce yellowish-tinged mucus when oil glands become clogged and infected.
Systemic Causes of Tear Discoloration
Yellow tears can originate from substances circulating in the bloodstream, reflecting a health issue that affects the entire body. The most significant systemic cause is high levels of bilirubin, a yellow pigment resulting from the breakdown of red blood cells. If the liver cannot process or excrete this bilirubin—due to conditions like hepatitis, cirrhosis, or gallstone blockage—the pigment builds up in the blood, causing jaundice.
While jaundice primarily causes yellowing of the skin and the whites of the eyes, excess bilirubin can enter the tear film. Certain medications can also cause tears to appear yellow or orange as a side effect. For example, the antibiotic Rifampin, used to treat tuberculosis, is excreted in tears and other bodily fluids, giving them a distinct orange-red color.
Drug-induced discoloration is not harmful, but it can permanently stain soft contact lenses. Some high-dose vitamins or chemotherapy agents can also be secreted into the tears, temporarily tinting the tear film. These systemic causes are less common than localized infections but point toward the body’s internal chemistry affecting eye secretions.
Determining When to Seek Medical Attention
If yellow tears are accompanied by other symptoms, seeking medical advice is important for a proper diagnosis. Consult a healthcare provider if the yellow discharge is thick, sticky, or persistent, especially if it lasts longer than a few days. This is particularly true if the eye is painful, red, swollen, or if the discharge causes the eyelids to be matted shut.
Immediate medical attention is necessary if yellow tears are associated with changes in vision, increased sensitivity to light, or a fever, as these may signal a more severe infection. If the yellowing of the tears is part of a wider yellowing of the skin or the whites of the eyes, it could indicate jaundice and requires immediate medical testing to evaluate liver function.