What Causes Yellowing of the Eyes?

Nov 18, 2021 Source: Cainiu Health

Dr. Cui Xin

Introduction

1. Aging: Long-term exposure of the conjunctiva (the membrane covering the surface of the eye) to external environmental factors leads to pigment deposition. 2. Unhealthy habits: Such as exposure to wind and sand causing eye irritation, or prolonged screen time using electronic devices. 3. Hepatobiliary diseases: Primarily hepatitis—including icteric hepatitis and cholestatic hepatitis. 4. Improper diet: Consumption of foods rich in beta-carotene or intake of colored medications may also cause yellowing of the sclera.

The eyes are the windows to the soul. In a healthy individual—regardless of iris color—the sclera (the “white” of the eye) should appear clean and bright white. However, we often observe that some people’s sclerae appear cloudy—either with visible blood vessels (subconjunctival hemorrhages) or yellowish discoloration. So, what causes yellowing of the sclera? Below, we address this question.

1 (7)_副本1.jpg

What Causes Yellowing of the Sclera?

1. Aging

Aging is an inevitable yet often unwelcome process. With advancing age, the sclera may gradually develop a yellowish hue. This occurs because prolonged environmental exposure leads to pigment deposition in the conjunctiva covering the sclera, eventually forming patchy yellow spots—giving the eyes of older individuals a dull, turbid appearance.

2. Unhealthy Habits

Many people habitually rub their eyes—especially when irritated by wind, dust, or after prolonged screen use causing dryness and discomfort. Though this is a natural reflex, rubbing introduces bacteria from the hands onto the ocular surface, potentially contributing to transient scleral yellowing. Fortunately, such yellowing typically resolves quickly.

3 (5)_副本1.jpg

3. Hepatobiliary Disorders

Yellowing of the sclera—also termed scleral icterus—is a classic clinical sign of hepatobiliary disease. Common conditions include viral hepatitis, icteric hepatitis, and cholestatic hepatitis. Hepatocellular jaundice results from hepatocyte necrosis, leading to abnormal yellow discoloration of the sclera. Obstructive jaundice, caused by biliary tract obstruction, also manifests as scleral yellowing.

4. Dietary Factors

Diet can also influence scleral coloration. Excessive intake of carotene-rich foods (e.g., carrots, sweet potatoes) or ingestion of certain colored medications may cause benign, reversible yellowing of the sclera; adjusting dietary habits usually restores normal appearance. Additionally, chronic malnutrition or vitamin deficiencies—particularly those impairing bilirubin metabolism—can elevate serum bilirubin levels, resulting in scleral yellowing.

Above are the primary causes of scleral yellowing. We hope this information proves helpful.

View All

Is yellowing of the eyes a sign of liver problems?

Yellowing of the eyes may be caused by liver disease, but it could also result from medication use, cholecystitis, or other reasons. If a patient needs to take sulfonamide drugs containing flavin derivatives for a prolonged period, it may lead to yellowing of the eyes. In addition, pancreatic head cancer can also cause yellowing of the eyes. It is important to seek timely medical evaluation at a specialized hospital and receive diagnosis and treatment under the guidance of a qualified physician to avoid delays in managing the condition.