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Why are my eyes yellow?

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Updated July 02, 2013

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Question: Why are my eyes yellow?
Answer: Most of us long to have vibrant, bright-white eyes. However, sometimes the eyes can develop a yellowish appearance. Some people refer to yellowish eyes as "looking jaundiced." Jaundice refers to a yellowing of the eyes from a build-up of a bilirubin in the eyes and the rest of the body. The correct term for yellow eyes is actually "icterus." Icterus refers only to the eyes, whereas jaundice refers to a yellow appearance in the eyes as well as the rest of the body.

Your eyes might appear yellow due to a simple, benign cause. But sometimes yellowish eyes can be a sign of something much more serious. Below are some conditions that can cause your eyes to appear yellow.

Subconjunctival Hemorrhage

The white part of your eye, known as the sclera, is covered by a thin, clear tissue called the conjunctiva. The conjunctiva also lines the inside of your eyelid, housing a meshwork of small, thin blood vessels. These small blood vessels are fairly fragile and can easily burst or break. When they break, blood leaks out and settles between the conjunctiva and the sclera. If the leak is small, a part of your eye may just seem a little red. However, if the leak is large enough, the entire white part of your eye may appear completely blood red and in some cases can actually bulge outward.

A subconjunctival hemorrhage often appears as a bright red pool of blood in your eye. The condition usually causes no pain or vision changes, but occasionally causes minor itching of the eye. A scratchy sensation may sometimes be felt upon blinking. A subconjunctival hemorrhage, or eye bleed, can be caused by the following:

  • Trauma
  • Hard coughing
  • Hard sneezing
  • Vomiting
  • Heavy lifting
  • Forceful hand rubbing of the eye
  • Constipation
  • Various eye infections
Occasionally, a subconjunctival hemorrhage can be a warning sign for diabetes, hypertension, bleeding or blood disorders, leukemia and sickle cell disease. It is important to have your optometrist or ophthalmologist examine the hemorrhage to identify a cause and rule out other possible health disorders. Visible blood in your eye due to subconjunctival hemorrhage will be slowly reabsorbed by your body. Most hemorrhages resolve within about seven days without treatment. A large subconjunctival hemorrhage, however, can take up to two to three weeks to go away. The redness may turn to a yellow-orange color, pink and then white again. Your eye will not be stained by the blood. Artificial tears may be applied to decrease any feelings of scratchiness.

Hyperbilirubinemia

Hyperbilirubinemia refers to increased levels of bilirubin. Bilirubin is a brownish yellow substance found in bile, a substance that breaks down fats. Bile is released into the small intestine by the gallbladder when it is needed to break down fats that are being digested. Bilirubin is produced when the liver breaks down old red blood cells. Bilirubin is then removed from the body through the stool (feces) and gives stool its normal brown color.

When an abnormally high number of red blood cells is broken down, bilirubin can build up quickly in the body. Liver disease can also cause bilirubin levels to be abnormally high. Too much bilirubin is one cause of a condition called jaundice, which causes the skin and eyes to become yellow. Doctors usually order several types of liver function tests to rule out liver problems. Once the cause of excess bilirubin is taken care of, yellowing of the eyes and skin often disappears. Liver problems can also occur from chronic drug and alcohol abuse and these conditions may be difficult to treat. Viral infections that occur in cases of hepatitis can also cause severe liver disease.

Leptospirosis

Leptospirosis is a rare infection caused by a bacterial called leptospira genus. People with this infection often develop significant yellowing of the eyes. This infection shows up more in warmer climates and places where a person has exposure to water that has been contaminated by animal urine. People with leptospirosis develop a cough, sore throat, headache, muscle and stomach pain and swollen lymph nodes. They also develop an enlarged spleen or liver. Fortunately, as long as the person has access to broad-spectrum antibiotics, the condition usually resolves completely.

Source:

Kabat, Alan and Joseph W. Sowka. Patient has two golden globes. Review of Optometry, 15 April 2013.

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