Yellow Eyes
Yellowing of the whites of the eyes, often an early sign of jaundice
Quick Facts
- Type: Eye/whole-body sign
- Common causes: Liver disease, gallstones, blood disorders
- Underlying cause: Bilirubin buildup
- Seek care: Yellow eyes with pain, fever, or dark urine
Overview
Yellow eyes describe a yellow tint in the normally white part of the eyes (the sclera). This is usually one of the earliest visible signs of jaundice, which is a buildup of a yellow pigment called bilirubin in the body. Bilirubin is produced when old red blood cells break down and is normally processed by the liver and removed in the stool.
When the system that handles bilirubin is disrupted — by a liver problem, a blockage in the bile ducts, or excessive breakdown of red blood cells — bilirubin builds up and stains the eyes and skin yellow. Because yellow eyes can be the first clue to a liver, gallbladder, or blood disorder, they should always be evaluated, especially when accompanied by other symptoms.
The whites of the eyes often show yellowing before the skin does, which is why people frequently notice this change first. The causes of jaundice are commonly grouped by where the problem lies: too much red blood cell breakdown before the liver, a problem within the liver itself, or a blockage of the bile ducts after the liver. Working out which group is responsible guides the tests and treatment that follow, so prompt evaluation is worthwhile even when you feel otherwise well.
Common Causes
Yellow eyes reflect a buildup of bilirubin, which can occur for several reasons:
- Liver disease: Hepatitis, cirrhosis, and other liver conditions impair bilirubin processing.
- Bile duct blockage: Gallstones or a narrowing or tumor blocking the flow of bile.
- Increased red blood cell breakdown: Conditions causing rapid breakdown (hemolysis) raise bilirubin.
- Alcohol-related liver damage: Heavy alcohol use can injure the liver.
- Certain medications and toxins: Some drugs can affect the liver.
- Inherited conditions: Mild, harmless conditions such as Gilbert's syndrome can cause occasional mild yellowing.
Associated Symptoms
The symptoms that accompany yellow eyes help reveal the cause and urgency:
- Yellowing of the skin as jaundice progresses
- Dark urine and pale, clay-colored stools
- Itchy skin
- Abdominal pain, especially in the upper right side
- Fatigue, nausea, loss of appetite, or unintended weight loss
- Fever, which with abdominal pain may signal a serious infection
Yellow eyes with severe abdominal pain, high fever, confusion, or significant vomiting can indicate a serious problem and need urgent care.
Diagnosis & Evaluation
Evaluation focuses on finding the source of the bilirubin buildup.
- History and exam: Reviewing alcohol use, medications, travel, and other symptoms, and examining the eyes, skin, and abdomen.
- Blood tests: Liver function tests, bilirubin levels, and tests for hepatitis and blood breakdown.
- Imaging: Ultrasound or other scans to check the liver, gallbladder, and bile ducts.
- Further tests: Additional studies if a blockage, infection, or specific liver disease is suspected.
Treatment & Management
Yellow eyes are a sign rather than a disease, so treatment targets the underlying cause.
- Liver conditions: Treatment of hepatitis, reducing alcohol, and managing chronic liver disease.
- Bile duct blockage: Removing gallstones or relieving a blockage, sometimes with a procedure or surgery.
- Blood disorders: Treating the cause of excessive red blood cell breakdown.
- Stopping the trigger: Discontinuing a responsible medication or toxin under medical guidance.
- Supportive care: Managing itching and other symptoms while the cause is treated.
Some mild inherited causes need no treatment and are harmless once confirmed. Because the same yellowing can come from very different problems, the priority is to identify the cause accurately so that treatment is directed at the right target rather than at the yellow color itself.
Self-Care & Prevention
- Limit alcohol to protect the liver
- Get recommended hepatitis vaccinations and practice safe food and hygiene habits
- Use medications only as directed and tell your doctor about all supplements
- Maintain a healthy weight to reduce the risk of fatty liver disease
- Seek care promptly if you notice yellowing of the eyes or skin
When to See a Doctor
See a doctor promptly if you notice yellowing of the eyes or skin, as it always warrants evaluation. Seek emergency care if yellow eyes come with:
- Severe abdominal pain, especially in the upper right side
- High fever and chills
- Confusion, drowsiness, or difficulty staying awake
- Vomiting blood or black, tarry stools
These can signal a serious liver or bile duct problem or infection and require immediate care.
Frequently Asked Questions
What causes yellow eyes?
Yellow eyes are caused by a buildup of bilirubin, a yellow pigment, usually from a liver problem (such as hepatitis or cirrhosis), a blockage in the bile ducts (such as gallstones), or excessive breakdown of red blood cells. It is often the earliest sign of jaundice.
Are yellow eyes always serious?
Not always, but they should always be checked. Some causes are mild, such as the harmless inherited condition Gilbert's syndrome, while others — like hepatitis, bile duct blockage, or significant liver disease — need prompt treatment.
What is the difference between yellow eyes and jaundice?
Yellow eyes are usually the first visible sign of jaundice. Jaundice is the broader yellowing of the skin and eyes caused by bilirubin buildup, and the eyes often show it before the skin does.
Can yellow eyes go away on their own?
It depends on the cause. Yellowing from a temporary or mild condition may fade once the cause resolves, but yellow eyes from liver disease or a blockage will not improve without treating the underlying problem, so evaluation is important.
When are yellow eyes an emergency?
Seek emergency care if yellow eyes come with severe abdominal pain, high fever and chills, confusion or drowsiness, or vomiting blood or black stools. These can indicate a serious liver or bile duct problem or infection.
References
- MedlinePlus, U.S. National Library of Medicine. Jaundice.
- Mayo Clinic. Jaundice in adults — Causes.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Liver disease.
- American Liver Foundation. Bilirubin and jaundice.