Yellow Eyes

The whites of your eyes (called the sclera) turn yellow when you have a condition called jaundice.

The whites of your eyes might turn yellow when your body has too much of a chemical called bilirubin, a yellow substance that forms when red blood cells break down. Normally, it's not a problem. Your liver filters bilirubin from your blood and uses it to make a fluid called bile. Bile moves through thin tubes (called bile ducts) to get to your digestive tract and then out of your body as waste.

But if you have too much bilirubin in your blood or if your liver can’t get rid of it fast enough, it builds up in your body and can turn your eyes yellow. That’s jaundice.

Common Causes of Yellow Eyes

Yellowing of your eyes might happen for many reasons, including: 

Hepatitis

Hepatitis is when your liver becomes inflamed. Often, the cause is a virus that infects liver cells, such the hepatitis A, B, or C. The infection may be short-lived (acute) or long-term (chronic), which means it lasts for at least 6 months.

Hepatitis damages the liver so it can’t filter bilirubin as well. This can lead to jaundice. Sometimes, drugs or autoimmune diseases (where your immune system attacks your body) can cause hepatitis.

Gallstones

These hard, pebble-like pieces of material form in your gallbladder, a small organ under your liver. Gallstones are the most common cause of blocked bile ducts.

Think of bile ducts like drainpipes. They carry the fluid from your liver to your gallbladder (where it’s stored) and then to the small intestine. If bile ducts are blocked by gallstones, bilirubin builds up in your blood. That causes the whites of your eyes to turn yellow.

Some rare liver diseases can also block bile ducts.

Drinking too much alcohol

If you drink heavily for a long time (usually at least 8 to 10 years), it can cause serious liver damage. In some people, it can lead to inflammation that destroys liver cells. Over time, scars may replace healthy liver tissue, making it harder for your liver do its job.

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Certain medicines

Medications that have been linked to jaundice include:

Liver infection

Hepatitis viruses are the most common causes of liver infection, but it can also result from parasites like liver flukes. You can get them from eating raw or undercooked fish or infected plants. The infection isn’t common in the U.S., but ascariasis, or roundworms, can get into and block your bile ducts.

A reaction to a blood transfusion

If you’re given blood that’s the wrong type -- for example, if you have type A blood but get type B -- your immune system might destroy the wrong blood, releasing bilirubin and causing jaundice. This problem is rare because of blood testing, but it’s considered an emergency.

Sickle cell anemia

Sickle cell diseases are especially common in people of African or Caribbean ancestry. They cause your body to make red blood cells that are sticky and curved and back up in your liver, and they die faster than your liver can filter them out. Bilirubin from these cells builds up in your body, causing jaundice.

Malaria

You get the parasite that causes malaria from a mosquito bite or through contact with infected blood. Your blood cells may burst or become damaged and get filtered out by your liver or spleen. The loss of red blood cells causes anemia and jaundice.

Cirrhosis

This condition causes scar tissue to replace healthy liver cells. It happens slowly over a long period. Many forms of liver diseases and conditions cause cirrhosis. The most common things that make it more likely are:

As more and more scar tissue forms, it's harder for your liver to work.

Nonalcoholic fatty liver disease

When too much fat builds up in your liver, even though you drink little or no alcohol, it’s called nonalcoholic fatty liver disease. A severe form of this condition, nonalcoholic steatohepatitis, leads to liver inflammation and scarring (cirrhosis).

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Hemolytic anemia

Anemia is a condition in which your blood lacks healthy red blood cells. There are many types. In hemolytic anemia, your body breaks down red blood cells too quickly. When that happens, it releases more bilirubin than your liver can handle.

You could be born with this type of anemia. Or it may stem from things like infections or autoimmune disorders.

Cancer

  • Liver cancer . Cancer that starts or spreads from the liver is the most common cause of jaundice in people who have cancer. It can damage liver cells or bile ducts, which affects how well bilirubin is processed.
  • Pancreatic cancer . Tumors in your pancreas can press on bile ducts. If bile can’t drain from your liver into your small intestine, bilirubin builds up. When pancreatic cancer spreads, it often goes to the liver. This can also cause jaundice.
  • Gallbladder cancer. This rare form of cancer doesn’t usually cause symptoms until the tumor grows large or the cancer spreads. When the tumor is big enough to block bile ducts, it can lead to jaundice.

Less-Common Causes of Yellow Eyes

Bile duct diseases

Gallstones are the most common bile duct disease, but some rare conditions could cause jaundice, like:

  • Biliary atresia. This is a bile duct blockage that usually affects infants 2 to 6 weeks after birth.
  • Primary biliary cholangitis. This destroys the bile ducts over time.
  • Primary sclerosing cholangitis. This causes scarring in the ducts.

Ulcerative colitis

Liver damage from ulcerative colitis can lead to primary sclerosing cholangitis and then jaundice.

Sarcoidosis

This inflammatory disease can trigger your immune system to attack your body’s tissues. If it damages your liver, you might have jaundice. Sarcoidosis can also cause small yellow bumps on your eye.

Amyloidosis

This condition causes the buildup of an unusual protein called amyloid in your tissues and organs. Jaundice can happen when the deposits are in your liver.

Pancreatitis

Jaundice is a common complication of pancreatitis, usually because of a blockage in your bile duct.

Gilbert syndrome

This rare condition only affects about 3% to 7% of people. If you're born with it, your liver doesn’t make enough of an enzyme it needs to process bilirubin. The result is higher levels of bilirubin in your blood and yellow eyes.

Dubin-Johnson syndrome is an even rarer disorder that affects your liver and can cause jaundice. It's passed down through families.

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Yellow Eyes in Infants

Many newborns have jaundice because of a minor buildup of bilirubin. You may notice:

  • Yellow eyes and skin, starting on their face and moving down their body
  • Poor feeding
  • More sleepiness

High levels of bilirubin can cause seizures, hearing loss, and brain damage. Your doctor should keep an eye on your baby’s bilirubin levels if they show signs of jaundice.

Your baby’s body gets rid of extra bilirubin through their poop. Breast milk has a laxative effect, so they poop more. They should breastfeed at least eight times a day. If you have questions or concerns, talk to a specialist called a lactation consultant.

Special lights can also help your baby’s body clear out extra bilirubin.

How to Get Rid of Yellow Eyes

Treating the cause of your yellow eyes should clear them up. For example, if a gallstone is blocking your bile duct, you might need to take medication or get a simple surgery. If you have hepatitis, your doctor might give you drugs to fight the virus. Or they might tell you to avoid drinking alcohol or taking certain medicines.

Outlook for Yellow Eyes

Cancerous tumors that block your bile duct and cirrhosis of the liver can be dangerous or deadly. But with treatment, most conditions that cause yellow eyes don’t lead to further problems. 

WebMD Medical Reference Reviewed by Gabriela Pichardo on May 10, 2020

Sources

SOURCES:

Cleveland Clinic: “Adult Jaundice,” “Gallstones,” “Anemia.”

Merck Manual: “Jaundice in Adults,” “Overview of Hepatitis,” “Alcoholic Liver Disease.”

Mayo Clinic: “Infant Jaundice,” Cirrhosis,” “Ascariasis,” “Nonalcoholic fatty liver disease,” “Primary biliary cholangitis,” “Primary sclerosing cholangitis.”

American Family Physician: “Jaundice in Adults.”

Johns Hopkins: “Hemolytic Anemia,” “Sickle Cell Disease.”

JAMA Oncology: “Jaundice (Hyperbilirubinemia) in Cancer.”

American Cancer Society: “Liver Cancer,” “Pancreatic Cancer,” “Gallbladder Cancer.”

NIH/Genetics Home Reference: “Gilbert Syndrome,” “Dubin-Johnson Syndrome.”

CDC: “Liver Flukes.”

Harvard Health Publishing: “Bile Duct Diseases.”

American Liver Foundation: “Treating Hepatitis C.”

Mount Sinai: “ABO incompatibility.”

National Health Service: “Jaundice,” Sickle cell disease.”

UpToDate: “Patient education: Jaundice in adults (The Basics).

CDC: “Malaria.”

Harvard Health Publishing: “Malaria.”

Crohn’s & Colitis Foundation: “Liver Complications Fact Sheet.”

American Society for Gastrointestinal Endoscopy: “Understanding Ulcerative Colitis.”

Foundation for Sarcoidosis Research: “Sarcoidosis.”

Leukaemia Foundation (Australia): “Amyloidosis: A guide for patients and families.”

Annals of Internal Medicine: “Obstructive Jaundice as a Complication of Pancreatitis.”

Children’s Hospital of Philadelphia: “Jaundice and the Breastfed Infant.”

Mayo Clinic: “Infant jaundice.”

StatPearls: “Jaundice.”

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