Yellow Eyes: Causes, Treatment & Help

Yellow eyes in most cases indicate disorders in the liver or gall bladder. If, in addition, yellowish discoloration of the skin and mucous membranes also occurs, one speaks of jaundice (icterus). Behind the symptom can be both harmless causes, such as a disturbed breakdown of metabolic products, but also serious blood and liver diseases. In any case, yellow eyes must therefore be clarified immediately by a doctor.

What are yellow eyes?

Infographic on the anatomy and structure of the liver. Click to enlarge. ”Yellow eyes” is when the sclera of the eye shows a significant yellowish deviation from its normal white color. Often, the yellowish discoloration is more intensely noticeable in the peripheral areas of the eyeball that are covered by the eyelids. Yellow eyes are not an independent disease, but an indicator of underlying diseases. If the yellowing is due to disorders of the liver or gall bladder, it is usually accompanied by a general yellowish discoloration of the skin and often by painful abdominal discomfort. Icterus may also occur in the context of blood disorders or intolerance to blood transfusions. Yellowing of the eyes can also be a symptom of the harmless, hereditary metabolic disorder Meulengracht’s disease (aka Gilbert’s syndrome). In all cases, yellow eyes are due to an excessive concentration of the bile pigment bilirubin in the blood, which in turn may be due to a variety of causes.

Causes

Most commonly, yellow eyes occur in the setting of jaundice. The bile pigment responsible for this condition is formed as a breakdown product during the decomposition of the red blood pigment hemoglobin. Normally, the initially non-water-soluble “indirect bilirubin” is metabolized in the liver to a water-soluble degradation product (“direct bilirubin”), passes through the bile into the intestine and is excreted. Elevated bilirubin levels are often caused by disturbances in this conversion process or in the outflow of bile, e.g. gallstones. However, the cause can also lie outside the hepatobiliary tract. This is the case, for example, when an excessive number of red blood cells spontaneously disintegrate. Reasons for this are hereditary or acquired blood diseases, immune diseases, infections (e.g. malaria), intolerance of blood transfusions, etc. Too much indirect bilirubin is produced, which the liver is unable to convert. If, on the other hand, the problem is liver dysfunction, liver inflammation (hepatitis) may be present. Excessive consumption of liver-damaging substances (alcohol, toxins and certain medications) also leads to a weakening of the organ. In rare cases, yellow eyes also occur temporarily after surgery, during pregnancy, and in newborns.

Diseases with this symptom

  • Gallstones
  • Gallbladder inflammation
  • Gallbladder cancer and bile duct cancer
  • Cholangitis (inflammation of the bile duct)
  • Hepatitis
  • Cirrhosis of the liver
  • Cholestasis
  • Liver failure
  • Pancreatitis (inflammation of the pancreas)
  • Yellow fever
  • Gilbert-Meulengracht disease
  • Right heart failure

Diagnosis and course

Yellow eyes are a noticeable symptom that usually makes sufferers see a doctor at an early stage. To track down the cause of the yellowing, the patient’s blood is first examined. The blood values provide information about potentially disturbed organ functions and abnormalities of the blood test sand components. In addition, a comprehensive medical history is taken to record the patient’s medical history and additional existing complaints – such as pain and digestive problems. Palpation of the abdominal organs may reveal pressure-sensitive areas in the liver and gallbladder. Ultrasound examinations as well as urine and stool samples, especially with regard to the coloration of the excretions, also point to possible causes of impaired bilirubin breakdown. In general, the prognosis of jaundice is highly dependent on the cause and timing of treatment initiation, especially if the yellow eyes are a consequence of a progressive liver degenerative disease.

Complications

Naming the complication is intended to discuss a confounding condition.The term complication declares a consequence of a health disorder or the concomitant of a medical preparation used against this disorder. Thus, complications can arise from a misdiagnosis as well as in the course of the medical procedure. Yellow eyes are a possible complication of liver or gall bladder disease, which are categorized as diseases of the digestive system. Yellow eyes can also bring other complications. Yellow eyes are caused by congestion of bile or an inverted position of the bile duct, which are caused, for example, by gallstones. Complications usually occur in debilitated patients. To avoid dangerous complications, a medical examination must take place after the first symptoms appear. Sometimes the sufferer should be treated in a clinic in the course of eliminating existing complications, such as yellow eyes. There, a concept for the following outpatient approach to yellow eyes or the actual condition can be determined. Yellow eyes are a complication of liver and bile diseases, not an independent clinical picture. A healthy lifestyle, avoidance of alcohol and sugar products, and periodic preventive care can prevent yellow eyes and liver-gall disease. A low-fat diet is sometimes indicated. Numerous medicinal preparations are harmful to bile and therefore should not be used in liver-gall disease.

When should you go to the doctor?

Yellow eyes are not an independent clinical picture, but always a symptom. The yellowing of the white portion of the eyeballs often indicates disturbed functions of the liver or gall bladder. They are often associated with other features of jaundice such as yellowing of the skin and mucous membranes and of the stool. For this reason alone, yellow eyes are reason to seek medical treatment immediately. This is by no means merely a cosmetic problem. Besides the liver-bile disorder, which is often the cause of yellow eyes, there are other reasons: For example, yellow eyes can also be due to elevated blood lipid levels that also require treatment, as well as various infections or diseases of the blood. In addition, some medications can cause yellow eyes. An immediate visit to the doctor on the basis of the indicator “yellow eyes” saves valuable time and, in extreme cases, can even save lives. At the very least, a disease detected as early as possible can be treated more easily and means less suffering for the patient. Particularly in the case of liver disease, pain often only occurs at a more advanced stage. Yellow eyes can therefore be seen as an early warning system. Conversely, however, eyes that are not yellow do not mean that everything is in order health-wise. Only the doctor can judge that.

Treatment and therapy

The treatment of yellow eyes depends on the diagnostically determined cause. Treatment options then depend on whether the cause is prehepatic (Latin pre =before; hepa=liver), hepatic, or posthepatic (Latin post=after) in nature. Treatment success varies depending on the severity of the disease. If hereditary Gilbert syndrome is present, treatment is usually neither possible nor necessary. In this case, the breakdown of bilirubin is slightly disturbed, but there is no serious disorder with disease value. It is nevertheless advisable for those affected to limit alcohol and medication consumption. In the case of prehepatic causes, various negotiation options are available to normalize the hemoglobin content by administering or withdrawing certain blood components. However, incompatibilities in the context of blood transfusions must be accepted in life-threatening cases. If acute or chronic hepatitis is present, antiviral drugs can be used to curb the inflammation in the case of infectious diseases. In cases of severe damage to liver tissue, liver transplantation may be necessary. In cases of posthepatic causes, i.e., disorders of bile flow, gallstones or narrowing of the bile ducts are usually removed or treated by minimally invasive surgical procedures.

Outlook and prognosis

Yellow eyes are not an expression of a specific eye disease; rather, they usually signal disease of the liver or gallbladder. Outlook and prognosis of yellow eyes therefore depend on the development and prognosis of the underlying primary disease.Conversely, this also means that a cure of the primary disease will automatically bring back the yellowing of the eyes, because it is a reversible symptom. If the yellowing of the eyes occurs in parallel with yellowing of the skin, there is most likely a causative hepatitis, liver cirrhosis or obstruction of the bile ducts. In all cases, there is an increased concentration of the bile pigment bilirubin, which is an intermediate product of the breakdown of the blood pigment hemoglobin. The outlook and prognosis of jaundice are thus directly dependent on the course of the triggering underlying disease. If the bile ducts are obstructed by gallstones, the bile fluid, including bilirubin, may back up, causing an increase in the bilirubin concentration in the blood that triggers jaundice. The outlook and prognosis in this case are positive, provided that the backlog in the bile ducts can be cleared and the elevated concentration of bilirubin is reduced. If medication use is the triggering factor for yellowing of the eyes, stopping the medication is sufficient for a positive prognosis.

Prevention

The best way to prevent yellow eyes is to adopt a lifestyle that is kind to the liver and gallbladder. This includes, in particular, moderate alcohol and medication consumption. The bile can be relieved by a low-fat diet. If traveling to exotic countries is planned, adequate vaccination against hepatitis A and B must be available and malaria prophylaxis must be considered. Food hygiene should also always be observed, as ingestion of toxic decomposition products and certain molds can damage the liver and thus be partly responsible for the occurrence of yellow eyes.

This is what you can do yourself

If the inside of the eye is yellowish in color, this indicates liver dysfunction. The yellow discoloration is due to an elevated bilirubin level, as metabolic products are no longer broken down sufficiently. There are numerous reasons for this, most of which require treatment. The most common cause is diseases of the liver and gall bladder, for example chronic or acute liver inflammation or gallstones. Self-help is of little use, because the cause must be treated. If the yellowing is accompanied by pain in the abdomen, a visit to the doctor is urgently recommended. Acute jaundice must be treated with medication. If the yellowing of the eyeball is due to excessive alcohol consumption, the patient must immediately stop drinking. If an addiction is behind it, it should be treated in an appropriate facility. Sometimes the yellowing of the eyes is due to a very high-fat diet. Here, too, the waste products of metabolism are deposited in the mucous membranes. A change in diet to a low-fat, vitamin-rich diet is advisable. During the first few days, the diet should be based on a light diet. If the discoloration of the eyeball is caused by minor injuries of the blood vessels, there is no reason for concern. However, if vision is impaired and the eyes hurt, the ophthalmologist should be consulted. In all other cases, cooling and protection of the eyes will help. If the blood can drain away unhindered again, the yellowing will also recede.