The sclera is the dense, fibrous layer that forms the white part of the eye. Its whiteness comes from the scattered arrangement of its collagen fibers. When the sclera loses its bright, clear appearance, it typically signals an imbalance, which can be environmental or internal. Understanding the reasons for this color change is the first step toward restoring a healthy look. This guide explores why the sclera changes color and outlines strategies, from habit changes to topical applications, designed to promote and maintain its natural whiteness.
Identifying the Root Causes of Discoloration
The appearance of color in the sclera is a manifestation of underlying physiological processes, with the hue indicating the nature of the issue. Yellowing, medically termed scleral icterus, is linked to the buildup of bilirubin in the bloodstream. Bilirubin is a yellowish pigment produced when old red blood cells are broken down.
Its accumulation occurs when the liver cannot process it efficiently, often pointing toward conditions like jaundice, hepatitis, or bile duct blockages.
Redness, or a bloodshot appearance, results from the dilation or bursting of the tiny blood vessels (conjunctival vessels) on the eye’s surface. Temporary causes include irritation from allergens, exposure to smoke or dust, or eye strain from prolonged focus. Acute redness can be caused by a subconjunctival hemorrhage, a broken blood vessel that appears as a bright red spot after forceful actions like coughing or sneezing.
A dull or slightly grayish hue is often attributed to lack of rest or dehydration, which affects the eye’s microcirculation. A bluish-grey tint can indicate scleral thinning, allowing the darker, underlying choroid tissue to show through. This thinning may be associated with long-term medication use, such as the antibiotic minocycline, or systemic conditions like certain forms of anemia or connective tissue disorders.
Lifestyle Changes for Sustained Whiteness
Achieving a sustained white sclera relies on systemic health and adopting long-term habits that support ocular function. A dietary approach rich in antioxidants can fortify the eyes against cellular damage and inflammation. Foods high in lutein and zeaxanthin, such as dark leafy greens like spinach and kale, are particularly beneficial, as they help protect eye tissues.
Consuming foods rich in Vitamin C, found in citrus fruits and berries, also supports the health of the small blood vessels within the eye. Proper hydration is paramount, as the tear film that lubricates the eye’s surface is primarily water. Aiming for the recommended intake of eight 8-ounce glasses of water daily ensures sufficient tear production, which flushes irritants and maintains a clear ocular surface.
Consistent, high-quality sleep is another fundamental component for eye whiteness. During sleep, the eyes undergo a restorative process, repairing minor damage and reducing the vascular engorgement that contributes to a tired, red appearance. Adults should aim for seven to nine hours of uninterrupted sleep for adequate recovery.
Managing prolonged screen time can significantly reduce redness and strain caused by digital fatigue. The 20-20-20 rule offers a simple technique: every 20 minutes, look at an object 20 feet away for at least 20 seconds. This practice relaxes the ciliary muscle responsible for focusing and encourages a higher blink rate, counteracting the dryness that often leads to eye irritation and redness.
Immediate and Topical Solutions
Topical applications offer temporary relief for quick cosmetic improvement. Over-the-counter eye drops fall into two categories: lubricating drops and vasoconstrictor drops. Lubricating drops, or artificial tears, moisturize the eye’s surface, clearing redness caused by dryness or mild irritation.
Vasoconstrictor drops contain ingredients like tetrahydrozoline or naphazoline, which physically shrink the tiny blood vessels in the sclera, immediately reducing redness. However, repeated use of these older decongestant drops is strongly discouraged due to the risk of “rebound redness.” When the effect wears off, blood vessels may dilate more than before, worsening the issue. Newer drops use brimonidine, which carries a lower risk of this rebound effect.
Applying a cold compress is a non-chemical method to temporarily reduce redness and puffiness. The cold temperature causes blood vessels to constrict, decreasing blood flow and reducing swelling. This method is soothing for eyes irritated by allergies or fatigue.
Cosmetic techniques can create the illusion of a whiter sclera using color theory. Blue or navy-toned eyeliner or mascara can counteract subtle yellow or red tones, as blue opposes red and yellow on the color wheel. Applying a nude or beige-toned eyeliner to the lower waterline, rather than a dark color, also helps brighten the area and neutralize redness along the rim.
When Discoloration Requires Medical Attention
While many causes of sclera discoloration are minor and temporary, some changes signal a need for professional medical intervention. Persistent or sudden yellowing, especially if accompanied by yellowing of the skin or unexplained fatigue, requires immediate consultation with a doctor. This may indicate liver dysfunction or a systemic issue requiring urgent diagnosis and treatment.
Eye redness that is severe, lasts longer than 48 hours, or is accompanied by other concerning symptoms warrants evaluation by an eye care specialist. These red flags include eye pain, increased sensitivity to light, or a noticeable change in vision. The presence of sticky discharge, crusting around the eyelids, or the feeling that something is lodged in the eye should also be assessed to rule out infection or serious inflammatory conditions.