Yellow Eyes: When to Be Concerned

Introduction

A person's eyes can offer personality insights, and at the same time, provide warning signs about the body's overall health. When the white portion of the eyes called sclera turns yellowish in color, it is often a signal that something is not right in the body. It also indicates a condition called jaundice. Jaundice is a condition in which the skin, whites of the eyes, and mucous membranes turn yellowish in color due to elevated levels of bilirubin in the blood. Bilirubin is a yellow-orange pigment that is created from the breakdown of red blood cells (RBCs). There are different causes of jaundice in newborns, children, and adults. 

Conditions That Cause Yellowing of the Eyes

Individuals who experience yellowing of the eyes may have a dysfunction in any of the following organs:

• Liver
• Gallbladder
• Pancreas
• Multiple organs

1. Liver Problems

The liver performs numerous essential body functions that are related to metabolism, digestion, storage of nutrients, and immunity, including the breakdown of red blood cells. The yellowing of the eyes can be caused by conditions that impair the normal functioning of the liver, such as cirrhosis or liver scarring. The following conditions can cause cirrhosis:

• Liver cancer
• Liver diseases
• Non-alcoholic fatty liver disease (NAFLD), especially in people who are obese
• Hepatitis B
• Hepatitis C
• Alcoholism or alcohol abuse

Other types of hepatitis such as hepatitis A, hepatitis D, and hepatitis E can also cause jaundice. However, they are less common to cause yellowing of the skin, eyes, and mucous membranes when compared with hepatitis B and hepatitis C. 

Genetic conditions such as hemochromatosis and Wilson's disease are also linked to cirrhosis development. 

• Hemochromatosis: This disease occurs when there is an iron overload in the body. Having excessive amounts of iron in the body is toxic and can poison different organs. An iron overload can also cause an organ failure. 

• Wilson's Disease: This is a rare genetic disorder that causes the accumulation of copper in the brain, liver, and other vital organs in the body. It can be a potentially life-threatening condition but can be effectively treated when early diagnosed. 

Aside from jaundice, the conditions that affect the liver may also cause the following symptoms:

• Sudden weight loss
• Loss of appetite
• Nausea
• Unexplained fatigue

2. Gallbladder Problems 

Bile is produced by the liver and then stored in the gallbladder. The gallbladder is the one responsible for the release of bile for the digestion of fats. It is also connected to the liver through the bile ducts. However, when there is an obstruction in the bile ducts due to gallstones, jaundice can happen. Other causes of gallbladder obstruction are tumors, cysts, and gallbladder inflammation, which can cause the following signs and symptoms:

• Fever
• Chills
• Abdominal pain
• Losing weight without trying

3. Problems with the Pancreas

The bile duct and pancreatic duct drain into the small intestine. However, if there is an obstruction in the pancreatic duct or a disease in the pancreas, bile may not properly drain. For this reason, jaundice can happen. This condition can also be caused by pancreatic cancer. 

Dark-colored urine, light-colored stools, and itchy skin may also occur due to increased levels of bilirubin in the body. The most common pancreatic conditions that can cause jaundice are:

• Gallstones
• Bile duct disorders
• Hepatitis and other types of liver disease

4. Certain Blood Disorders

Yellowing of the eyes can also be due to an abnormal red blood cell breakdown or impaired bilirubin excretion. These conditions include:

• Sickle cell anemia
• Drug-induced immune hemolytic anemia (DIIHA)
• ABO incompatibility reaction (receiving the wrong blood type during a blood transfusion)

Yellowing of the Eyes in Newborns

Newborns who develop jaundice is quite common since their liver is still developing. Jaundice tends to occur in newborns since their liver is not mature enough to remove bilirubin. Aside from a yellow skin discoloration, another obvious sign of jaundice in newborns is the yellowing of their eyes. 

Other symptoms of newborn jaundice, which should be immediately checked by healthcare professionals include:

• Fever
• Lack of energy
• Feeding problems
• Irritability

In most cases, newborn jaundice goes away as the infant's liver matures. The normal causes of newborn jaundice are:

• Physiological Jaundice: Most newborns experience physiological jaundice because of their still-developing liver. This type of jaundice usually appears 2-4 days after birth. 

• Breastfeeding Jaundice: This type of jaundice occurs when an infant does not get enough breast milk to flush out excess bilirubin. Breastfeeding jaundice is usually resolved when a mother's milk comes in. 

• Breast Milk Jaundice: In some instances, there are substances in the breast milk that can cause the intestines of infants to hold bilirubin instead of excreting it via the stool. Breast milk jaundice often goes away by the 12th week. 

There are also concerning causes of newborn jaundice. They include:

• Hyperbilirubinemia of Prematurity: Preterm infants have an increased risk of developing jaundice due to their still immature liver. They also tend to develop more severe jaundice, especially when they also have other conditions. 

• Blood Incompatibility Jaundice: A blood type incompatibility happens when the mother and baby have incompatible blood types. Such incompatibility causes the mother's body to attack the baby's red blood cells (RBCs) while still in the womb. Since the mother's antibodies attack the RBCs of the baby before birth, jaundice may occur as early as the first day of the infant's life. 

• Hemorrhage: Jaundice can also be due to internal bleeding. Preterm infants often have an increased risk of hemorrhages. 

• Infections: A severe bacterial infection called sepsis can also cause jaundice in newborns. 

Yellowing of the Eyes in Children and Adults

When older children and adults develop yellowing of the eyes, it is a cause for concern since jaundice is uncommon these age categories. Although consuming excessive orange or yellow-colored vegetables can make the skin turn yellowish, having yellow eyes often indicates jaundice or a sign of an underlying health problem. 

Jaundice mainly occurs in older children and adults due to the following reasons:

• Breakdown of Red Blood Cells: When RBCs are rapidly broken down, an increase in the production of bilirubin also happens. 

• Liver Disease or Injury: Problems in the liver can be due to acute or chronic hepatitis, alcoholic liver disease, drug-induced hepatitis, or cirrhosis, which often cause jaundice. 

• Bile Duct Obstruction: In bile duct obstruction cases, bilirubin builds up in the liver and cause jaundice due to the increasing bilirubin levels in the blood. 

Other causes of jaundice that need medical treatment include:

• Acute Inflammation or Liver Disease: If the liver infected or injured, the liver may be unable to properly process bilirubin. 

• Hemolytic Anemia: This is a blood disorder in which the RBCs are rapidly destroyed before their normal lifespan is over. This disorder can also lead to anemia, which is a condition characterized by low hemoglobin or RBC count. 

• Pancreatitis: This condition refers to the inflammation of the pancreas, which can also lead to jaundice. 

• Malaria: This is a serious and potentially life-threatening disease caused by a parasite that infects certain mosquitoes that feed on human blood. This parasite can cause the destruction of red blood cells (RBCs) and often leads to jaundice. 

• Cancer: Liver cancer and pancreatic cancer can cause jaundice. 

Other symptoms that occur along with jaundice may include:

• Fever
• Weakness
• General feeling of being unwell
• Abdominal fullness or bloating
• Itchy skin
• Dark-colored urine
• Passing pale stools

The excessive consumption of foods that are rich in vitamin A or beta-carotene can result in having a yellowish skin discoloration. Some examples of these types of food are melons, squash, and carrots. Although these foods tend to affect skin color, they cannot cause yellow eyes.