The whites of your eyes, known as the sclera, are usually a uniform white. A greyish discoloration can be a common concern. While often harmless, a change in sclera color can sometimes signal underlying health conditions.
Understanding Scleral Discoloration
One reason for grey discoloration is normal pigmentation, known as scleral melanocytosis or ocular melanosis. This condition results from melanin accumulation, the natural pigment that colors skin, hair, and eyes. It is usually present from birth or early childhood and appears as harmless grey or bluish spots on the sclera.
Another factor is scleral thinning, leading to blue sclera. When scleral tissue is thinner than usual, the underlying choroid, which contains blood vessels, can show through, giving the eye a bluish or grayish tint. While normal in infants and young children due to thinner sclera, in adults, it might indicate systemic conditions like osteogenesis imperfecta (brittle bone disease) or Marfan syndrome, which affect connective tissue.
Age-related changes can also contribute to a grey appearance, such as arcus senilis. This condition involves a grey, white, or bluish ring that forms around the cornea, not directly on the sclera, due to lipid deposits. Arcus senilis is common with increasing age, especially after 60, and is generally considered benign. However, in younger individuals (under 40), its presence can sometimes indicate elevated cholesterol or triglyceride levels, warranting further investigation.
Certain mineral or drug deposits can also lead to greyish scleral discoloration. For instance, prolonged silver exposure, known as argyria or argyrosis, can cause permanent bluish-blackish discoloration of the skin and eyes. Similarly, long-term use of medications like the antibiotic minocycline or antipsychotics such as chlorpromazine can deposit pigments in the sclera. Iron deficiency anemia has also been linked to a bluish tint in the sclera.
Accompanying Symptoms and Indicators
When the whites of the eyes appear grey, accompanying symptoms can provide important clues about the underlying cause. Changes in vision, such as blurriness or double vision, may suggest a significant issue. Eye discomfort, including pain, redness, or discharge, alongside the discoloration, warrants attention.
Systemic symptoms can also be present. For example, if grey sclera is due to conditions like osteogenesis imperfecta, individuals might also experience bone fragility or hearing loss. Skin discoloration could also be present if the cause relates to certain mineral or drug deposits, like the generalized slate-grey pigmentation seen in argyria. Changes in overall well-being, such as unexplained fatigue or altered energy levels, may also prompt a broader medical evaluation.
When to Seek Medical Advice
Consult a healthcare professional if you notice a grey discoloration in the whites of your eyes, especially if it appears suddenly. Medical advice is also recommended if the grey color is accompanied by other concerning symptoms, including eye pain, changes in vision, or unusual eye discharge.
A check-up is prudent if the discoloration is new or has progressed in an adult. If there is a known family history of conditions linked to scleral changes, such as connective tissue disorders, a medical evaluation can help assess potential risks. An eye care specialist can determine if the discoloration is benign or a symptom of an underlying condition.
Diagnostic Steps and Management
A medical professional will conduct a thorough eye examination to assess the nature and extent of the scleral discoloration. This includes reviewing your medical history, noting medications, and discussing other symptoms. Depending on initial findings, further diagnostic steps may include blood tests for specific indicators, such as cholesterol levels, iron levels, or genetic markers if a systemic condition is suspected.
In some instances, imaging studies might be considered for a more detailed view of the eye’s structures or to investigate potential systemic causes. If the grey sclera is determined to be a benign condition, such as age-related arcus senilis or scleral melanocytosis, specific treatment may not be necessary, and regular monitoring might be recommended. However, if the discoloration is linked to an underlying systemic condition, management will focus on addressing that condition. For example, managing cholesterol levels might be advised for problematic arcus senilis, or discontinuing certain medications if they are identified as the cause of deposits.