Yellowing of the whites of the eyes (scleral icterus) is a sign of elevated bilirubin in the blood. Bilirubin is a yellow pigment from red blood cell breakdown. This discoloration indicates an underlying health issue. Scleral icterus is a symptom, not a condition, and often precedes jaundice (widespread yellowing of the skin).
Understanding the Causes of Yellow Eyes
Yellow eyes result from bilirubin accumulation (hyperbilirubinemia). The liver processes bilirubin, filtering it from blood and releasing it into bile. Disruption causes bilirubin buildup and yellowing.
Causes of elevated bilirubin categorize into three types: pre-hepatic, intra-hepatic, and post-hepatic. Pre-hepatic causes involve excessive red blood cell breakdown. Examples include hemolytic anemia, where red blood cells are destroyed rapidly, and certain genetic conditions like sickle cell anemia.
Intra-hepatic causes involve liver issues affecting bilirubin processing. Liver diseases such as hepatitis (viral, alcoholic, or autoimmune), cirrhosis, and fatty liver disease impair liver function. Certain medications, including high doses of acetaminophen, penicillin, and some oral contraceptives, also damage the liver, leading to yellow eyes. Genetic conditions like Gilbert’s Syndrome, affecting bilirubin processing, are factors.
Post-hepatic causes involve bile duct blockages preventing bilirubin drainage. Common culprits include gallstones, obstructing ducts, and tumors in the pancreas, gallbladder, or bile ducts. Pancreatitis, an inflammation of the pancreas, also leads to bile duct obstruction and bilirubin buildup.
Treatment and Reversing Yellow Eyes
Reversing yellow eyes depends on diagnosing and treating the cause. Once addressed, bilirubin levels return to normal, and discoloration subsides.
For conditions like viral hepatitis, antiviral medications treat the infection, allowing the liver to heal and process bilirubin. If a bile duct blockage, often caused by gallstones, present, procedures like surgery or ERCP may remove the obstruction and restore bile flow.
Managing liver diseases, such as non-alcoholic fatty liver disease (NAFLD) or alcohol-related liver disease, involves lifestyle adjustments. Dietary changes, weight management, and alcohol abstinence are strategies to help liver recovery and reduce bilirubin. In cases of severe liver damage, a liver transplant may be considered for function.
When yellow eyes result from blood disorders like hemolytic anemia, treatments include medications, blood transfusions, or therapies to stabilize red blood cell production and breakdown. If certain medications cause yellowing, discontinuing or adjusting the offending drug’s dosage resolves the issue.
When to Seek Professional Medical Advice
Yellow eyes always warrant prompt medical evaluation. Seek urgent medical attention if yellow eyes are accompanied by other symptoms.
These can include:
- Dark urine
- Pale stools
- Abdominal pain
- Nausea
- Vomiting
- Unexplained weight loss
- Fatigue
- Itching
- Fever
These symptoms can signal severe issues requiring immediate diagnosis and intervention to prevent complications or organ damage. Medical consultation allows professionals to conduct tests, such as blood work and imaging, to identify the cause and initiate treatment.
Preventive Measures and Ongoing Care
Maintaining overall health, particularly liver health, helps prevent yellow eyes. A balanced diet (fruits, vegetables, whole grains, lean proteins) supports liver function. Limiting processed foods and unhealthy fats also contributes to liver well-being.
Moderate alcohol consumption, or complete avoidance if liver issues exist, is important; excessive alcohol damages the liver. Practicing good hygiene, including vaccination against hepatitis A and B, prevents viral infections impacting liver health. Avoiding recreational drug use reduces liver damage risk.
Managing chronic health conditions, such as diabetes and high cholesterol, with regular check-ups and medication adherence, contributes to systemic health and supports liver function. These proactive measures and medical oversight help prevent the development or recurrence of yellow eyes.