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My daughter, an upstate New Yorker, is spending the semester in Costa Rica. She is vaccinated against hepatitis A and B. She told me that her sclera have become yellow recently. She is feeling fine—no vomiting, abdominal discomfort, nausea, lethargy or other illness. Is it possible that it is just from the sun? She wears contacts a lot, and did comment that since she has been trying to wear sunglasses more she thinks the eyes are less yellow. Should I tell her to find an eye doctor in Costa Rica? Or an MD? Or is this of minor concern? She does not drink alcohol.
Yellow sclera, as you appear to have realized, can be a sign of jaundice, which is caused by an increase in the level of bilirubin in the bloodstream. Jaundice usually occurs due to conditions that cause liver damage or dysfunction. Vaccination against hepatitis A and B does not protect from all forms of infectious hepatitis. If the entire white portion of both eyes appears yellow, jaundice is probably the cause and your daughter should be evaluated by an internist, rather than by an ophthalmologist. On the other hand, if the yellow discoloration is focal—just involving a small part of the white part of the eye—then your daughter should be seen by an ophthalmologist. Focal yellow discoloration can be caused by a number of problems such as a pingueculum or pterygium. These conditions are caused by sun exposure.
Answered by: David K. Coats, MD
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