Yellow Eyes: Causes and What They Reveal About Your Health
Yellow eyes (sclerenicterus) are caused by an increased level of bilirubin in the blood and are usually an indication of diseases of the liver or biliary tract1. In many cases, jaundice (jaundice) is behind it, less often the harmless Gilbert syndrome2. In newborns, a slight yellowing is common and usually harmless3. If yellow eyes occur in adults, the cause should be clarified by a doctor.
In jaundice (jaundice), the blood concentration of the pigment bilirubin is greatly increased4. This is a yellowish-brown dye that is produced during the breakdown of red blood cells.
If it is not excreted, it deposits in the tissue. As a result, the skin, mucous membrane and especially the whites of the eye can turn yellowish. Common accompanying symptoms are light stool and dark-colored urine.
Yellow eyes can occur at any age. Most often, however, newborns show this symptom.
You can find out exactly what can be behind yellow eyes and jaundice, why it is not a disease and when you should visit an ophthalmologist in this article.
Causes of yellow eyes
In healthy people, the dermis of the eye (sclera) is always white. If this eye discoloration changes, it usually has pathological causes. In this case, you should urgently consult an ophthalmologist.
Yellowing of the eyes is referred to in medicine as conjunctival or scleral jaundice. This usually occurs as a result of jaundice, which is accompanied by increased concentrations of the pigment bilirubin. This not only changes the color of the eyes, but also the skin.
Jaundice itself is not a disease, but a symptom1. However, as it can indicate liver malfunction, liver disease, gallbladder and bile ducts, it should not be ignored.
Yellow eyes can occur at any stage of life. The causes and frequencies differ in the individual age groups.
Typical causes of jaundice in older children or adults include:
- Infection or inflammation of the liver (hepatitis, liver inflammation)
- Autoimmune diseases: These can also cause hepatitis, as they attack your own immune system.
- Bile: When gallstones block the bile ducts so that the bile cannot drain properly (=obstructive jaundice).
- Liver cirrhosis: The tissue of the liver changes and restricts organ function.
- Rarer medical causes: inflammation of the pancreas, certain blood diseases, malaria, specific cancers or rare genetic defects
Effects of liver and bile
The liver is the largest metabolic organ in humans. It is responsible for carrying bilirubin out of the body. This is a degradation product of the red blood pigment hemoglobin. Under normal circumstances, this is filtered out of the blood via the liver.
The pigment is removed via the bile fluid, which is temporarily stored in the gallbladder and finally excreted via the intestine as a waste material. This keeps the bilirubin levels in balance.
If the function of the liver or biliary tract is disturbed, the bilirubin cannot be excreted, a metabolic disorder may occur. Instead, it concentrates in the blood. It causes discoloured skin and yellow eyes.
The more bilirubin accumulates in the body, the darker the coloration becomes. The eyes are usually affected first. However, yellow eyes do not cause problems directly on the eyes.
Yellow eyes in jaundice – newborns
Jaundice is much more common in newborns than in the elderly. After birth, babies’ bodies begin to break down excess red blood cells, producing a great deal of bilirubin.
In these amounts, the pigment can often not yet be completely filtered by the liver. The concentration increases and the excess bilirubin is deposited in the tissue.
As a result, almost 60 percent of newborns suffer from yellowing of the eyes and skin3. As a rule, this is not a cause for concern. The yellow coloration disappears relatively quickly.
Yellow eyes – treatment and treatment options
The yellowing of the eyes does not affect eye health. Nor is it the actual disease. It is an indication of a deeper cause. The treatment is carried out according to the underlying disease.
In order to detect these correctly, a measurement of the bilirubin concentration in the blood is usually carried out first. A large blood count is taken and the liver is examined.
The diagnosis is made taking into account other side effects such as light stools and dark urine, fatigue, fever or sudden weight loss. Appropriate therapy is initiated.
Corresponding options are:
- Virus-inhibiting drugs for infectious diseases such as hepatitis
- Abstention from alcohol or certain medications if these are responsible for the increased bilirubin concentration 5
- Adapted healthy diet to relieve the liver
- Drink a lot.
The yellowing of the eyes decreases on its own with an improvement in liver function.
Only in rare cases, surgery of the liver or to expose the bile ducts may be necessary.
Yellow eyes – do I need to see an ophthalmologist?
When is an appointment with an ophthalmologist advisable? If the dermis in the eye turns yellow, this is usually an indication of impaired liver function, diseases of the liver and biliary tract.
Since these are important for detoxification in the body, the change in eye colour should always be clarified by an ophthalmologist such as Doctor-medic Liliana Bányai at the eye laser centre in Stuttgart or Karlsruhe.
This is the only way to initiate appropriate therapy at an early stage and to treat the underlying disease in order to avoid major complications. Read more about the eye!
What can be other symptoms of eye problems?
- Burning
- Gluing
- Eye pain up to eye migraine
- Weakening of the connective tissue (“lacrimal sacs”)
- Barley grain
- Inflammation of the edge of the eyelid
- Irritated eyes with itching (herpes on the eye)
- Sensitivity to light
- Tearing eyes or increased tear production
- Blurred vision
- Dark dark circles due to lack of sleep – How can I remove dark circles?
- Redness of the eyelids (eye twitching)
- Dry eyes after surgery (called Sicca syndrome)
- Constant pressure on the eyes
- Red eyes and/or inflammation of the conjunctiva
- Eye secretion.
Frequently Asked Questions about Yellow Eyes
Not always. Yellow eyes are caused by increased bilirubin in the blood, and the liver is the most common cause, but not the only one1. Biliary tract diseases, certain blood diseases or harmless Gilbert’s syndrome (affects 3-8% of the population) can also lead to a slight yellowing 2. In the case of persistent yellow eyes, you should have the cause clarified by a doctor.
A slight yellowing at the edge of the sclera (sclera) may indicate a minimally elevated bilirubin level. Often the Gilbert syndrome is behind it, an inherited, benign metabolic variant2. The yellow coloration is typically visible in natural light from a bilirubin value of about 2.5 mg/dL 4. If in doubt, a simple blood test can provide clarity to the doctor.
Yes. Excessive alcohol consumption can lead to alcohol-related liver disease, in which the liver can no longer sufficiently break down bilirubin 5. In advanced cases (alcoholic hepatitis or cirrhosis of the liver), yellowing of the eyes is one of the typical symptoms. In case of suspicion, a doctor should be consulted immediately.
You should seek medical attention promptly if the yellowing appears suddenly, becomes stronger, or is accompanied by symptoms such as fever, abdominal pain, light stools, dark urine, or unexplained weight loss 1. In newborns, mild jaundice in the first few days is usually harmless, but should be monitored by the pediatrician as the intensity increases 3.
Not in most cases. Around 60% of all newborns develop a visible yellowing in the first days of life because the liver does not yet fully manage the breakdown of bilirubin 3. Jaundice usually resolves itself within one to two weeks. However, if bilirubin levels rise sharply, phototherapy (light therapy) may be necessary to avoid complications.
References
1 Nelson M, Mulani SR, Saguil A (2025): Evaluation of Jaundice in Adults. American Family Physician.
2 De Silva AP, Nuwanshika N, Niriella MA, de Silva HJ (2025): Gilbert’s syndrome: The good, the bad and the ugly. World Journal of Hepatology, 17(2):98503.
3 Kemper AR, Newman TB, Slaughter JL et al. (2022): Clinical Practice Guideline Revision: Management of Hyperbilirubinemia in the Newborn Infant 35 or More Weeks of Gestation. Pediatrics, 150(3):e2022058859.
4 Ruiz MA et al. (1997): The clinical detection of scleral icterus: observations of multiple examiners. Military Medicine, 162(8):560-563.
5 Singal AK, Mathurin P (2021): Diagnosis and Treatment of Alcohol-Associated Liver Disease: A Review. Jama, 326(2):165-176.
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