Yellow Eyes

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Introduction

What are yellow eyes?

Yellow eyes occur when the whites of the eyes (sclerae) take on a yellowish tinge. Also known as scleral icterus, yellow eyes are generally a sign of jaundice caused by a buildup of bilirubin in the blood. Bilirubin is a yellow-colored pigment that is produced by the breakdown of old red blood cells. Bilirubin is normally processed by the liver and released into the intestine in bile before being excreted from the body through the feces.

Yellow eyes in newborn infants

It is not unusual for newborn babies to have yellowing of the skin and eyes due to a condition called newborn jaundice. Newborn jaundice is common, and in many cases, it is not a cause for alarm and requires no treatment. However, it is important to immediately notify your infant’s health care provider if you notice yellowing of the eyes or skin in your baby so that your baby’s condition and bilirubin levels can be evaluated, monitored and treated if needed.

High or quickly rising levels of bilirubin in newborns can lead to serious or life-threatening complications, such as cerebral palsy and brain damage. Seek prompt medical care if you notice that your baby has yellowing of the eyes or skin. Early monitoring and treatment of high levels of bilirubin reduce the risk of complications.

Seek immediate medical care (call 911) if your baby has symptoms, such as weak sucking, inability to feed, unresponsiveness, lack of wet or dirty diapers, a stiff or limp body, strange eye movements, severe jaundice, or you have trouble waking up your baby.

Yellow eyes in children and adults

In children and adults, yellow eyes, as well as jaundice of the skin, occur when bilirubin builds up because of serious diseases and conditions that cause liver damage or dysfunction, or block the bile ducts. The bile ducts transport bile to the digestive tract to be mixed with feces. Certain conditions of the gallbladder or pancreas, such as pancreatitis or gallstones, can cause obstruction of the bile ducts, which leads to jaundice and yellowing of the eyes.

Serious liver diseases include hepatitis and cirrhosis. Certain blood disorders, such as hemolytic anemia, can also cause yellow eyes because of the abnormal destruction of red blood cells and increase in bilirubin production. Yellow eyes and jaundice in children and adults are treated by diagnosing and treating the underlying cause.

Seek prompt medical care if you or your child has yellow eyes or a yellow tint to the eyes without any other symptoms. Early diagnosis and treatment of the cause of yellow eyes can reduce the risk of serious complications, such as liver failure.

Seek immediate medical care (call 911) if you, or someone you are with, have serious symptoms that may be associated with yellow eyes and jaundice, such as lethargy or unresponsiveness, confusion, difficulty breathing, or a change in consciousness or alertness. You should also seek immediate medical care (call 911) if you, or someone you are with, have overdosed on a drug or ingested a toxic substance.

Symptoms

What other symptoms might occur with yellow eyes?

Yellow eyes may accompany other symptoms, which vary depending on the underlying disease, disorder or condition. Children and adults with yellow eyes due to jaundice often have other symptoms of an underlying disease. However, newborn infants with yellow eyes due to mild jaundice often do not have any other symptoms.

In children, adolescents and adults, symptoms that may appear along with yellow eyes and skin (jaundice) include:

Symptoms that might indicate a serious or life-threatening condition

Symptoms that may occur with yellow eyes or skin can be caused by life-threatening conditions, such as liver failure, portal hypertension, or esophageal varices. Seek immediate medical care (call 911) if you, or someone you are with, have any of the following symptoms:

Seek immediate medical care (call 911) if your baby has any of the following symptoms that may accompany yellow eyes:

  • Extreme fussiness

  • Inability to be easily woken

  • Lack of stool or urine

  • Serious feeding problems or inability to breast-feed or bottle feed

  • Unresponsiveness

  • Unusually weak, stiff or floppy body

Causes

What causes yellow eyes?

Yellow eyes are typically due to jaundice. Normally, the body continuously replaces older red blood cells with new ones. A yellow pigment called bilirubin is left behind from this process. Bilirubin is processed by the liver and expelled from the body in a substance called bile, which also contains substances to help digestion. Bile flows through the bile duct into the small intestine to aid in digestion and eventually mixes with stool for elimination.

Yellow eyes and jaundice are caused by an underlying disease, disorder or condition that causes a problem with this process, leading to a buildup of bilirubin in the body.

Causes of yellow eyes in newborns

Yellowing of the eyes and skin is common in newborns due to physiological jaundice, which is usually not serious and often disappears within two weeks after birth. A pregnant woman’s liver processes the fetus’ bilirubin before birth. After birth, the baby’s liver begins to function and process bilirubin, but may not process the bilirubin in sufficient quantities during the first several days. Physiological jaundice can result in temporary yellowing of the eyes and skin that is often not serious or harmful. Breastfeeding can also contribute to newborn jaundice. Eating high amounts of carotene-rich foods such as carrots, squash, and sweet potatoes can also cause reversible (nonjaundice) yellowing of the eyes.

Serious, but less common, causes of newborn jaundice include:

  • Biliary atresia (blockages in the ducts carrying bile from the liver to the gallbladder)

  • Certain blood disorders or abnormalities

  • Certain inherited disorders

  • Infection

  • Liver disease

Although yellow eyes or skin in newborns is often not serious, it is important to notify your infant’s health care provider immediately if you notice yellowing of the eyes or skin in your baby so that your baby’s condition and bilirubin levels can be evaluated, monitored and treated if needed.

Causes of yellow eyes in children and adults

Yellow eyes, as well as yellowing of the skin, occur in children and adults when bilirubin builds up due to serious diseases and conditions that cause liver damage or dysfunction, or block the bile ducts. Certain conditions of the gallbladder or pancreas, such as pancreatitis or gallstones, can cause obstruction of the bile ducts that leads to jaundice and yellowing of the eyes.

Liver or biliary-system causes of yellow eyes include:

  • Bile duct narrowing or obstruction (due to gallstones or pancreatitis)

  • Cancer including that of the liver and pancreas

  • Cirrhosis (liver scarring due to a variety of liver diseases)

  • Drug-induced cholestasis (slowing of bile flow due to medications)

  • Hepatitis (liver inflammation, which can be caused by alcoholism, medications or infection)

  • Ischemic hepatocellular jaundice (due to a lack of blood or oxygen reaching the liver)

  • Pregnancy-induced obstruction of the bile ducts

Other causes of yellow eyes include:

  • Hemolytic anemia (condition in which the body destroys too many of its own red blood cells)

  • Malaria (disease in which parasites destroy red blood cells)

  • Pterygium or pinguecula (both conditions are slightly raised yellow growths on the cornea and conjunctiva which cover the sclera of the eye, often caused by sun exposure). Pterygium and pinguecula are generally mild conditions and not related to jaundice or underlying causes.

  • Sickle-cell anemia (inherited disease characterized by abnormally shaped red blood cells)

  • Staining of the eyes with an orange-yellow dye used to diagnose eye injuries. This is harmless and temporary.

What are the potential complications of yellow eyes?

Complications of yellow eyes, and jaundice in general, vary depending on the underlying disease, disorder or condition.

Complications of yellow eyes in children and adults

Yellow eyes and jaundice in adults are often due to serious conditions, such as liver disease, that can lead to serious and life-threatening complications including:

Complications of yellow eyes in newborns

In newborns, very high or rapidly rising levels of bilirubin, which cause jaundice, can lead to a rare but serious complication called kernicterus, a type of brain damage. Kernicterus can lead to the following conditions:

  • Cerebral palsy

  • Hearing loss

  • Teeth and vision problems

You can help minimize your risk of serious complications by seeking regular medical care and following the treatment plan you and your health care professional design specifically for you or your child.

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Medical Reviewer: William C. Lloyd III, MD, FACS
Last Review Date: 2018 Dec 28
  1. Cirrhosis. PubMed. U.S. National Library of Medicine.    https://www.ncbi.nlm.nih.gov/pubmedhealth/PMHT0022024/
  2. Facts about Jaundice and Kernicterus. Centers for Disease Control and Prevention (CDC). https://www.cdc.gov/ncbddd/jaundice/facts.html
  3. Jaundice. MedlinePlus, U.S. National Library of Medicine.     https://medlineplus.gov/ency/article/000210.htm
  4. Liver Disease. American Association for Clinical Chemistry. https://labtestsonline.org/understanding/conditions/liver-disease.html
  5. The Progression of Liver Disease. American Liver Foundation.  http://www.liverfoundation.org/abouttheliver/info/progression  
  6. Portal Hypertension. Vascular Disease Foundation. http://vasculardisease.org/flyers/portal-hypertension-flyer.pdf
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