Jaundice describes a yellowish tint to the skin and the whites of the eyes.
Excessively high levels of bilirubin in the blood cause jaundice. Bilirubin is a yellow waste substance found in bile, the liquid the liver makes to help break down fats.
Too much bilirubin in the bloodstream can cause leaks into surrounding tissues, such as the skin and eyes. This causes them to turn yellow.
Jaundice has different causes in adults, children, and newborn infants.
Causes in newborns
Yellow eyes are normally a symptom of jaundice, especially in newborns.
Jaundice is very common in newborn infants because the liver is still maturing.
Bilirubin often builds up faster than the immature liver of an infant can break it down, causing jaundice to occur frequently.
Aside from a yellowing of the skin, one of the clearest signs of jaundice in an infant is the yellowing of the eyes.
Yellow eyes are only one symptom of newborn jaundice. New parents should also watch for the following symptoms:
- yellow skin
- lack of energy
- trouble with eating
A medical professional should check any newborn with these symptoms immediately.
Most cases of newborn jaundice are harmless and resolve without treatment as the liver matures.
The causes of normal neonatal jaundice include:
- Physiological jaundice: Many newborns have this type of jaundice, due to the liver's early stage of development. It normally appears when an infant is between 2 and 4 days old.
- Breast-feeding: Breast-feeding can cause jaundice when an infant does not receive enough breast milk to flush the bilirubin out. This type of jaundice often resolves when a mother's milk comes in.
- Breast milk: Occasionally, substances in breast milk cause the intestines of a newborn to retain bilirubin rather than excrete it in stools. This form of jaundice normally resolves itself by 12 weeks of age.
Some causes of newborn jaundice require further treatment. These include:
- Blood incompatibility jaundice: When a mother and a fetus do not have compatible blood types, the mother's body may attack the red blood cells of the fetus while it is in the womb. As the mother's antibodies are already breaking down the infant's red blood cells before birth, this type of jaundice may occur as early as 1 day old.
- Jaundice of prematurity: Premature babies are at the greatest risk of jaundice because their livers are highly underdeveloped. Premature babies may have more severe jaundice or jaundice alongside a number of other conditions.
- Infections: Some bacterial infections, such as sepsis, can cause newborn jaundice.
- Hemorrhage: Internal bleeding can cause jaundice. Premature infants face a particularly high risk of hemorrhages.
While most infants have mild-to-moderate jaundice, more severe cases occur. Cases of mild jaundice might resolve without treatment while more moderate jaundice can be treated with phototherapy.
Doctors can treat extremely severe cases using a blood transfusion. A pediatrician will examine an infant for jaundice at their first checkup.
Causes in children and adults
Liver problems can lead to yellowing in the eyes.
In older children and adults, yellow eyes often indicate a more serious problem because jaundice is not common in these age groups.
Unlike yellow skin, which might occur as a result of eating too many yellow and orange vegetables, yellow eyes are nearly always a sign of jaundice. Yellow eyes and jaundice in older children and adults normally indicate an underlying medical issue.
There are three main reasons for jaundice to occur:
- Liver disease or liver injury: Liver problems cause a type of jaundice known as hepatocellular jaundice.
- Breakdown of red blood cells: When the body breaks down red blood cells too quickly, an increase in bilirubin production can cause jaundice.
- A blockage in the bile duct system: When a blockage occurs in the tubes that carry the bile from the liver to the gallbladder and intestines, bilirubin cannot leave the liver and builds up. This type of jaundice is called obstruction jaundice.
A number of medical conditions that require medical treatment can cause any of these types of jaundice.
These conditions include:
- Acute inflammation or infection of the liver: An injured or infected liver may not be able to process bilirubin properly.
- Inflammation or obstruction of the bile duct: Swollen or blocked bile ducts prevent the release of bile into the liver. When bile is not released, the liver cannot dispose of bilirubin.
- Hemolytic anemia: Hemolytic anemia is a blood disorder that occurs when the body breaks down red blood cells too quickly. The production of bilirubin increases. This can lead to anemia, in which someone does not have enough red blood cells.
- Malaria: This mosquito-borne blood infection can cause jaundice.
- Pancreatitis: An infection of the pancreas that causes it to swell can lead to jaundice.
- Certain cancers: Some cancers can cause jaundice, including cancers of the liver and pancreas.
- Medications: Yellow eyes can be a side effect of taking acteaminphen, penicillins, oral contraceptive, and anabolic steroids.
- Cirrhosis: Scarring of the liver can reduce its ability to filter bilirubin, which then flows back through the blood and reaches the eyes and skin, turning them yellow.
Older children and adults may notice yellowing of the skin and eyes without other symptoms. Jaundice often occurs with other uncomfortable symptoms, however, including:
- itchy skin
- feeling unwell
- fullness in the stomach
- pale stools
- dark urine
A physician should look at all sudden cases of jaundice in adults and older children to rule out serious causes.
A few harmless causes of jaundice in older children and adults are less common.
For example, Gilbert's syndrome is a genetic liver condition in which the liver does not process bilirubin properly. Gilbert's syndrome may cause occasional bouts of jaundice and irritable bowel syndrome (IBS).
However, the condition does not impact the health of the person overall or increase their risk of complications.
Anatomy of the eye
Jaundice affects the whites, or sclerae, of the eyes.
Jaundice mainly affects the front of the eye, as this is where the yellow pigment would be visible.
It is important to understand the anatomy of the front of the eye to understand how jaundice affects the eye.
The front part of the eye is made of several different parts:
- Eyelid and lashes: The upper and lower lids and lashes offer eyes protection from dirt and dust. They are also used to blink, so that the eyes stay moist. Jaundice can cause both the outer eyelids and the underside of the eyelid to have a yellow tint that is visible on lifting the eyelid.
- Pupil: The pupil is the dark center of each eye that controls the amount of light that enters. Jaundice does not normally discolor the pupils.
- Iris: The iris is the colored part of the eye immediately surrounding the pupils. It contains muscles that contract the pupils. Yellowing may be seen in the iris if a person has jaundice.
- Sclera: These are the whites of the eye. The sclera surrounds the iris and protects the fragile structures on the inside of the eye. Jaundice are often first noticed because the sclera becomes yellow.
If you have yellow eyes as an older child or adult, visit a doctor.