The appearance of yellow eyes, medically termed scleral icterus or jaundice, is a visible sign of an internal malfunction. This discoloration occurs when bilirubin, a yellow pigment, builds up in the bloodstream and deposits in tissues, including the whites of the eyes. Since this is a symptom of an underlying medical disorder, it cannot be resolved quickly with superficial remedies. Finding a “fast” solution requires immediate professional diagnosis and treatment to identify the cause.
The Mechanism Behind Yellow Eyes
The yellowing of the eyes is a direct result of hyperbilirubinemia, an elevated level of bilirubin in the blood. Bilirubin is a natural byproduct of the body’s process of breaking down old red blood cells, a process called hemolysis. Hemoglobin from these cells is converted into unconjugated bilirubin, which is not water-soluble and must be transported to the liver bound to albumin protein.
Once unconjugated bilirubin reaches the liver, it undergoes conjugation, a chemical process that makes it water-soluble. This conjugated bilirubin is then excreted by the liver into the bile ducts. The bile flows into the small intestine to aid digestion and is expelled from the body, primarily in the stool.
When this normal process is disrupted, bilirubin builds up in the blood. The sclera of the eye is particularly susceptible to this buildup due to its high elastin content, making the yellow discoloration visible once serum bilirubin levels exceed approximately 3 milligrams per deciliter.
Common Medical Conditions That Cause Yellowing
Conditions causing yellow eyes are categorized based on where they disrupt the bilirubin pathway: pre-hepatic, hepatic, or post-hepatic. Pre-hepatic causes occur before the liver and involve excessive red blood cell breakdown, overwhelming the liver’s processing capacity. Examples include various types of hemolytic anemia, such as sickle-cell disease, or an adverse reaction to a blood transfusion.
Hepatic causes involve damage or disease within the liver, impairing its ability to absorb, process, or excrete bilirubin. This category includes viral infections like Hepatitis A, B, or C, alcohol-related liver disease, cirrhosis, and drug-induced liver injuries. Genetic conditions, such as Gilbert’s syndrome, can also mildly impair conjugation, leading to intermittent, slight yellowing.
Post-hepatic or obstructive causes occur after the liver, where a physical blockage prevents conjugated bilirubin from draining into the small intestine. The most common cause is the presence of gallstones, which can obstruct the bile ducts. Other obstructive causes include inflammation of the pancreas (pancreatitis) or tumors in the bile ducts or pancreas.
Urgent Steps for Immediate Evaluation
The only safe and effective action when noticing yellow eyes is to seek immediate medical evaluation. The yellowing requires professional diagnosis, especially when accompanied by symptoms suggesting an urgent problem. A fever, sudden abdominal pain, confusion, or severe weakness alongside yellow eyes warrant an emergency room visit.
For diagnosis, a doctor will order blood tests to measure total bilirubin levels, distinguishing between unconjugated and conjugated types. A complete blood count (CBC) and liver function tests (measuring enzymes like AST and ALT) are routinely performed to assess liver health and check for excessive red blood cell destruction.
Imaging tests, such as an ultrasound of the abdomen, are frequently used if a blockage is suspected. This allows the doctor to visualize the liver, gallbladder, and bile ducts to look for physical obstructions like gallstones or tumors. The combination of patient history, laboratory results, and imaging provides the treatment plan.
Addressing the Root Cause for Clearance
Yellow eyes will only clear once the underlying medical condition causing the bilirubin buildup is successfully treated. There are no eye drops, supplements, or diets that can safely or quickly resolve the yellowing without eliminating the root cause. Treatment pathways are entirely dependent on the diagnosis and may involve medical or surgical interventions.
If the cause is liver inflammation, such as viral hepatitis, treatment focuses on managing the infection with antiviral medications and supporting liver recovery. For alcohol-related liver damage, complete abstinence is necessary for healing.
In cases of obstructive jaundice caused by gallstones, a procedure like endoscopic retrograde cholangiopancreatography (ERCP) may be used to remove the stone, or surgery may be required. If the yellowing is due to accelerated red blood cell breakdown, the focus shifts to managing the underlying blood disorder, such as hemolytic anemia.
Only targeted treatment of the specific disease will return the body’s bilirubin processing pathway to normal. Once bilirubin levels drop into the healthy range, the pigment will gradually be cleared from the sclera, and the yellow appearance will fade.