Why Are My Eyes Yellow?

Icterus is a term that means having a yellow tint to the eyes. If your eyes turn yellow, it may be caused by a condition called jaundice, the build-up of a yellow substance (bilirubin) created when old blood cells are replaced.

In addition to jaundice, yellow eyes can have other causes, such as bleeding in the eye.

This article will discuss more about potential causes of yellow eyes and how you can treat it.

Subconjunctival Hemorrhage (Eye Bleed)

An eye bleed (subconjunctival hemorrhage) can look like a bright red pool of blood in your eye. As the blood breaks down and is cleared from the eye, it can turn yellow. This gives your healing eye a yellowish look.

The white part of your eye (the sclera) is covered by a thin, clear tissue (conjunctiva). The conjunctiva has many tiny blood vessels that can easily burst or break.

If the vessels break, blood leaks and fills the space between the conjunctiva and the sclera. If the leak is small, a part of your eye may look discolored—maybe yellow or a little red. If the leak is big, the entire white part of your eye can look bright red.

A blood leak usually does not hurt or cause vision changes, but it can cause itching. You might notice a scratchy feeling when you blink.

Causes

A subconjunctival hemorrhage can be caused by several things, including:

• Trauma
• Hard coughing and/or sneezing
• Vomiting
• Heavy lifting
• Rubbing the eyes
• Constipation
• Eye infections

Occasionally, an eye bleed is a warning sign of a condition like diabetes, hypertension, bleeding or blood disorders, leukemia, or sickle cell disease.

An eye specialist can look at the eye and figure out what is causing the discoloration.

Treatment

Most cases of subconjunctival hemorrhage get better on their own without treatment. If the scratchy feeling in your eye is bothersome, artificial tears can help.

Any blood that you can see in your eye will slowly get reabsorbed by your body. Most hemorrhages of this type go away by themselves in about seven days. However, a larger eye bleed can take two to three weeks to get better.

The redness in your eye may turn to a yellow-orange color, then pink, then back to white again. While it can be odd, know that the color change from the blood in your eye is not permanent.

Hyperbilirubinemia

Having too much bilirubin in your blood (a condition called hyperbilirubinemia) can also make your eyes and skin appear yellow.

Bilirubin is made when the liver breaks down old red blood cells. The liver gets rid of bilirubin by including it in bile.

Bile is then released by the gallbladder into the small intestine to break down fats during digestion. Bilirubin leaves the body through stool and is what gives it a normal brown color.

Causes

When an abnormally high number of red blood cells is being broken down, bilirubin can build up quickly in the body.

Medical conditions can cause bilirubin levels to be higher than normal, including:

• Liver disease
• Blocked bile ducts
• Hemolytic anemia
• Genetic disorders like Gilbert syndrome

Certain over-the-counter (OTC) medications, prescription medications, or herbal supplements can also affect the liver, especially when they’re taken for a long time.

Higher than normal bilirubin levels can also be caused by:

• Tylenol (acetaminophen)
• Statins
  
• Antifungal medications
• Anticonvulsant medications
• Oral contraceptives (birth control)
• Herbal supplements like ginseng, comfrey, kava, and sassafras

Treatment 

Healthcare providers can use blood tests called liver function tests to check for liver problems. They can also order imaging tests to look at the liver and any other organs that might not be working as they should be.

The treatment for high bilirubin will depend on what’s causing the buildup.

For example, it might be enough to stop or change medications. If a bile duct is blocked, this can usually be fixed with surgery. There are special therapies for people with liver disease. In severe cases, they might need to have a liver transplant.

Once the cause is found and treated, any yellow discoloration in the eyes or the rest of the body should go away.

Leptospirosis

Leptospirosis is an infection caused by Leptospira bacteria. It can make humans and animals sick.

People infected with leptospirosis may not have symptoms. Some people develop jaundice, which can make their eyes and skin look yellow.

Causes

Leptospirosis is most common in warmer climates and in places where people are exposed to water that has been contaminated by animal urine.

Other symptoms of leptospirosis include:

• Cough
• Fever
• Headache
• Muscle pain
• Stomachaches
• Enlarged spleen or liver

The symptoms of leptospirosis can come in waves or phases. In the first phase, common symptoms like a fever come on quickly, but then a person starts to feel better. They might just think they had a “bug” that was going around.

However, if the infection is not treated and goes on to the second phase, a person can get very sick. They might develop severe medical problems like organ failure and meningitis.

Treatment

Since leptospirosis is caused by bacteria, most people need to take antibiotics such as doxycycline or azithromycin to treat the infection.

If they get treated early, most people recover in a few weeks. If the infection is not treated, a person can be sick for months.

People who have complications and are very ill might need to be in the hospital to get antibiotics through an IV.

Alcohol Use Disorder

Alcohol use disorder is a chronic disease that causes people to misuse alcohol. People with alcohol use disorder are at a high risk of getting alcoholic liver disease. Yellow eyes and skin in someone who is misusing alcohol are usually a sign that their liver is damaged.

Causes

Drinking a lot of alcohol over time can damage the liver. Other liver problems like inflammation (hepatitis) and scarring (cirrhosis) can also cause jaundice.

Treatment

Treatment for liver problems that are caused by alcohol is to stop drinking—but it’s not really that simple.

To get better, a person who misuses alcohol needs a lot of medical and mental health support. They also need support from the people in their lives.

People who need to stop using alcohol because their liver is damaged might need to be in the hospital—especially when they first stop drinking.

Once they are medically stable, rehabilitation programs can be an option to help them continue to abstain from alcohol.

Pancreatitis

Pancreatitis is inflammation of the pancreas. The organ produces enzymes the body needs for digestion.

People with pancreatitis can have flare-ups or “attacks,” during which time they have abdominal pain, nausea and vomiting, and other symptoms. They may also have jaundice, which can cause their eyes to look yellow.

These acute attacks can repeat over time, becoming chronic. As they happen more often, the flares can damage the pancreas.

Causes

Pancreatitis can happen for a variety of reasons related to lifestyle, medications, and other health conditions.

Here are some examples of things that can cause pancreatitis:

• Alcohol use
• Certain medications
• Inflammatory bowel disease
• High triglyceride levels
• High calcium levels
• Pancreatic cancer
• Viral or bacterial infections
• Exposure to toxic chemicals
• Abdominal trauma
• Problems with structures that support the pancreas (e.g., ducts, blood vessels)

Sometimes, people have pancreatitis and there is no clear cause.

Treatment

A person who is having a pancreatitis attack will often feel, and look, very ill. They may go to the emergency room and even be admitted to the hospital for treatment.

A “flare” of pancreatitis will get better on its own. People who have pancreatitis can try to manage the condition by making lifestyle changes, such as avoiding alcohol and certain foods.

When the condition becomes chronic, the damage to the pancreas can lead to other serious health problems.

If a person has pancreatitis because of gallstones, they might need to have surgery to have the stones or their gallbladder removed.

Hemolytic Anemia

Hemolytic anemia is a blood disorder where the body breaks down red blood cells too quickly. As a result, the body does not have enough red blood cells (anemia).

When red blood cells are breaking down too fast, it causes bilirubin buildup. This can make a person’s eyes look yellow.

Causes

Some people are born with hemolytic anemia because they inherited certain genes from their parents. In people with inherited hemolytic anemia, red blood cells in the body don’t live long enough.

Hemolytic anemia is also a condition a person can get later in life (acquired). Some people will only have the condition for a short time, while others will have it for the rest of their lives.

Acquired hemolytic anemia can happen when a person’s body starts destroying red blood cells. This can be triggered by infections, medications, cancer, and autoimmune diseases.

In rare cases, people develop hemolytic anemia after getting a blood transfusion or because they have a mechanical heart valve that destroys red blood cells.

Treatment

Generally, people with hemolytic anemia need a combination of treatments depending on how sick they are.

If a person has hemolytic anemia that is not very severe and is not getting worse, they may not need any specific treatment.

For people who are sicker, corticosteroids and other medications that strengthen the immune system can be helpful.

More severe anemia might need to be treated with blood transfusions, bone marrow transplants, surgery, and drugs that suppress the immune system.

Summary

It can be alarming to look in the mirror and see that your eyes are looking yellow.

While the color can be caused by a broken blood vessel in your eye that will get better by itself, it could also be a sign of a more serious problem like liver disease or bacterial infections.

The only way to know for sure is to have your healthcare provider look at your yellow eye. Once they know what’s causing the discoloration in your eye, they can make sure you get the right treatment.