The white part of the eye is known as the sclera. Changes to the sclera’s usual bright white color can signal issues ranging from simple irritation to serious systemic disease. When the eyes turn yellow, red, or develop chronic growths, it indicates an underlying process. This process may be localized to the eye’s surface or originate from internal organs. Recognizing the color change helps determine the cause and whether medical attention is necessary.
Causes of Yellowing in the Sclera
Yellowing of the sclera indicates an excessive accumulation of bilirubin in the bloodstream. Bilirubin is a yellowish pigment created during the breakdown of old red blood cells. Normally, the liver filters bilirubin into bile for excretion. If the liver cannot process bilirubin or if bile ducts are blocked, the pigment builds up, causing hyperbilirubinemia.
The causes of this buildup fall into three main categories: liver diseases (such as hepatitis or cirrhosis), obstruction of bile flow (due to gallstones or tumors), and blood disorders (like hemolytic anemia) that cause rapid red blood cell breakdown. Yellowing often appears before the skin yellows and may be accompanied by dark urine, pale stools, fatigue, and abdominal pain. Any noticeable yellowing requires immediate medical evaluation to identify and treat the underlying systemic issue.
Understanding Redness and Bloodshot Eyes
Redness in the eyes is caused by the dilation or rupture of tiny blood vessels within the conjunctiva. This redness can appear as a diffuse, widespread pattern indicating irritation or infection, or as a localized patch signaling a small hemorrhage.
Diffuse redness is commonly caused by environmental irritants like smoke, dust, or allergens, which trigger inflammation. Widespread redness is also characteristic of conjunctivitis (pink eye), which is inflammation of the conjunctiva due to viral, bacterial, or allergic causes. Dry eye syndrome causes persistent irritation because insufficient tears fail to lubricate the ocular surface adequately.
A localized deep red patch is usually a subconjunctival hemorrhage, occurring when a small blood vessel beneath the conjunctiva breaks. This condition is typically harmless and results from minor trauma, a forceful sneeze, coughing, or straining. A hemorrhage is usually painless, does not affect vision, and resolves on its own within one to two weeks.
Chronic Deposits and Pigmentation Changes
The sclera can develop non-white appearances due to chronic, localized changes, often linked to environmental exposure. These changes, such as pinguecula and pterygium, are surface-level growths associated with prolonged exposure to ultraviolet (UV) light, wind, and dust.
A pinguecula appears as a small, yellowish, slightly raised bump typically located on the sclera near the nose. It is a non-cancerous deposit confined to the conjunctiva without encroaching upon the cornea. While usually benign, a pinguecula can become inflamed (pingueculitis), causing redness, irritation, and a gritty sensation.
A pterygium, sometimes called “surfer’s eye,” is a fleshy, wedge-shaped growth that distinguishes itself by extending onto the clear cornea. This growth is vascularized and, as it progresses, can distort the cornea’s shape, potentially leading to astigmatism or blurred vision.
Next Steps and Seeking Medical Advice
If the eyes exhibit a yellow tint, a physician should be consulted without delay. This signals a systemic issue and is urgent if yellowing is accompanied by fever, abdominal pain, unexplained weight loss, or changes in stool or urine color.
For acute redness, immediate attention from an eye care specialist is necessary if there is severe eye pain, sudden vision reduction, light sensitivity, or a headache. These symptoms can indicate a serious condition, such as acute glaucoma or keratitis, requiring prompt treatment to prevent lasting vision damage.
If the discoloration is due to a chronic deposit like a pinguecula or pterygium, an eye care professional can monitor the growth. They may recommend protective measures, such as wearing UV-blocking sunglasses, or treatment involving lubricating eye drops or, in severe cases, surgical removal. A comprehensive eye exam is necessary to establish an accurate diagnosis.