Blue sclera is when the typically white part of the eye (sclera) appears bluish, blue-gray, or blue-purple. This is a common and usually normal finding in newborns and infants. The bluish color is often temporary, signaling a stage in their early development.
Why Babies Have Blue Sclera
Infants display blue sclera because their eye structure at birth is unique. A baby’s sclera, the protective outer layer of the eye, is naturally thinner and more translucent than an adult’s. This translucency allows underlying vascular layers to become visible. The dark pigmentation of the choroid, a blood-rich layer beneath the sclera, and tiny blood vessels can show through. The sclera is composed mainly of collagen fibers, which are still developing and less dense in infants, contributing to this see-through effect.
Typical Fading Timeline
The bluish tint in a baby’s sclera resolves as they grow and their eyes mature. This natural progression means the blue color becomes less noticeable by around six months of age, though it can persist up to the first year, or sometimes into the toddler years. As the infant develops, the collagen fibers within the sclera thicken and become more opaque. This thickening process obscures the underlying choroid and blood vessels, leading to the gradual disappearance of the bluish hue. The fading of blue sclera is a normal part of ocular development in most healthy infants.
When to Consult a Doctor
While blue sclera is often benign in infants, medical consultation is warranted in specific circumstances. Consult a doctor if the bluish color is unusually dark, appears extreme, or persists significantly beyond infancy. Medical attention is also important if blue sclera is accompanied by other symptoms. These can include signs of bone fragility (e.g., frequent fractures) or hearing loss. Joint hypermobility or unexplained developmental delays alongside blue sclera also prompt a medical assessment.
Persistent blue sclera can indicate an underlying medical condition affecting connective tissues. Conditions like Osteogenesis Imperfecta (brittle bone disease) are characterized by defects in collagen formation, leading to fragile bones and thin sclera. Ehlers-Danlos Syndrome, another connective tissue disorder, can similarly result in a thin sclera. Severe iron deficiency anemia has also been linked to blue sclera, as iron plays a role in collagen production. While these conditions are uncommon, a doctor can determine the cause and recommend appropriate management.