Why Do Newborns’ Sclerae Appear Blue?

Blue-tinged sclerae (the “whites” of the eyes) in newborns may result from a normal physiological phenomenon or, less commonly, from osteogenesis imperfecta (commonly known as “brittle bone disease” or “glass baby syndrome”). In newborns, the sclera is still underdeveloped and relatively thin and translucent; this allows the underlying third layer of the sclera—rich in bluish connective tissue—to show through, giving the sclera a bluish hue. As the infant grows, the sclera gradually thickens and matures, and the bluish tint typically resolves spontaneously. However, if the blue sclera is associated with osteogenesis imperfecta, prompt medical evaluation is essential.