When the whites of your eyes take on a yellowish hue, it signifies jaundice. This discoloration is not a condition itself, but a symptom of an underlying medical issue. It indicates a disruption in the body’s normal processes.
Understanding the Causes
The yellowing of the eyes, skin, and mucous membranes occurs due to a buildup of a substance called bilirubin in the body. Bilirubin is a yellowish pigment formed during the natural breakdown of old red blood cells. Normally, the liver processes this bilirubin, converting it into a form that can be excreted from the body, primarily through bile and then into stool. Causes of elevated bilirubin can be broadly categorized based on where the issue originates in this process.
Pre-hepatic causes occur before bilirubin reaches the liver, often due to an excessive breakdown of red blood cells. Conditions like hemolytic anemia, where red blood cells are destroyed too rapidly, can overwhelm the liver’s processing capacity. Other examples include blood disorders like sickle cell anemia, spherocytosis, or thalassemia, and infections like malaria, which also lead to increased red blood cell destruction.
Hepatic causes involve problems within the liver itself, where its ability to process or excrete bilirubin is impaired. Liver inflammation, known as hepatitis, caused by viruses (like hepatitis A, B, or C) or autoimmune disorders, can directly affect liver function. Chronic alcohol consumption can lead to alcohol-related liver disease, including alcoholic hepatitis or cirrhosis, scarring the liver and impairing its function. Nonalcoholic fatty liver disease and certain medications, such as high doses of acetaminophen, penicillin, oral contraceptives, or anabolic steroids, can also injure the liver, leading to bilirubin accumulation. Genetic conditions like Gilbert’s syndrome or Dubin-Johnson syndrome involve inherited defects in how the liver handles bilirubin, resulting in its buildup.
Post-hepatic causes arise after the bilirubin has been processed by the liver, typically involving a blockage in the bile ducts that prevents bile from draining properly. Gallstones are a common culprit, as they can obstruct the flow of bile from the liver and gallbladder into the small intestine. Inflammation of the gallbladder or bile ducts, pancreatic tumors, or bile duct cancer can also compress or block these ducts, causing bilirubin to back up into the bloodstream.
Other Signs to Watch For
Yellow eyes are often accompanied by additional symptoms that can provide clues about the underlying issue. These may include:
- Dark urine, occurring when excess bilirubin is excreted through the kidneys.
- Pale or clay-colored stools, if bilirubin does not reach the intestines.
- Skin itching, resulting from bile salt buildup under the skin.
- Fatigue.
- Digestive disturbances like nausea, vomiting, or appetite loss.
- Abdominal pain, particularly in the upper right side.
- Fever and chills, suggesting infection or inflammation.
- Unexplained weight loss.
When to Seek Medical Help
Yellow eyes always require medical evaluation, as they indicate an underlying health problem. Do not delay seeking medical attention if you notice this discoloration. Prompt diagnosis and treatment can help prevent complications and ensure a better outcome.
Certain accompanying symptoms warrant immediate medical care. If yellow eyes develop suddenly, especially with severe abdominal pain, high fever, or confusion, urgent medical attention is necessary. Rapidly worsening symptoms or new, severe symptoms alongside yellow eyes also signal a need for immediate evaluation. Ignoring these signs could lead to more serious health issues or organ damage.
How Yellow Eyes Are Diagnosed and Treated
Diagnosing the cause of yellow eyes typically begins with a thorough physical examination and a review of your medical history. A healthcare provider will often look for other signs of liver disease and ask about any accompanying symptoms. Blood tests are a standard next step, including measurements of bilirubin levels to confirm its elevation and liver function tests to assess liver health. A complete blood count may also be performed to check for conditions like hemolytic anemia. If hepatitis is suspected, specific blood tests to detect viral markers might be ordered.
Imaging tests are frequently used to visualize the liver, gallbladder, bile ducts, and pancreas to identify any structural abnormalities or blockages. An ultrasound is often the initial imaging test, followed by a CT scan or MRI if more detailed images are needed. In some cases, more specialized procedures like an endoscopic retrograde cholangiopancreatography (ERCP) may be performed to directly examine and potentially treat issues within the bile ducts.
Treatment for yellow eyes is entirely dependent on the specific underlying cause identified through diagnosis. Since yellow eyes are a symptom, addressing the root problem is the primary focus. For instance, if viral hepatitis is the cause, antiviral medications may be prescribed. If alcohol-related liver disease is diagnosed, cessation of alcohol consumption is a crucial part of treatment. When gallstones are blocking bile ducts, medication might be used to dissolve them, or surgical removal of the gallbladder may be necessary. For certain genetic conditions like Gilbert’s syndrome, specific treatment may not be required, while others might involve managing symptoms or specialized therapies. If the cause is drug-induced liver injury, discontinuing the offending medication is essential. The goal of treatment is to resolve the condition causing the bilirubin buildup, allowing the eyes to return to their normal white appearance.