Pre-hepatic sclera icterus occurs before bilirubin reaches the liver, hepatic or hepatocellular scleral icterus occurs when bilirubin has reached the liver, and post-hepatic or cholestatic occurs after when bilirubin has been conjugated in the individual’s liver. Scleral icterus can occur before, during, and after liver processing activity depending on what is causing the liver to malfunction. When the liver doesn’t function as it should, bilirubin isn’t released out of the person’s body and it remains circulating in blood and ends up in different parts of the individual’s body including the eyes. The coloring of the person’s eyes may fall under three classes: 1,2,3 However, sclera icterus doesn’t affect a person’s vision. Scleral icterus makes the white of eyes to become dark taking hues of bright yellow to something like dark orange. If the liver doesn’t function properly, the levels of this substance may elevate in blood causing sclera icterus or yellowing of a person’s eye part that is normally white in color. Bilirubin passes through the liver prior to being excreted from an individual’s body. Scleral icterus is linked to disorders of the liver that affect how the substance is expelled from the body. 2 Causes of Scleral Icterusīilirubin has an orangey to yellow appearance and it is created when red blood cells are broken down. Once the underlying condition is resolved, the discoloration may resolve or even managed. Scleral icterus may also indicate that there is obstruction of blood flow that prevents a person’s body from eliminating waste. Scleral icterus isn’t a disorder or disease in itself, but rather a symptom of an underlying condition or disease, usually of the liver. The classic definition of scleral icterus is excessive presence of a substance known as bilirubin in an individual’s bloodstream that causes the whites of eyes to have a yellowish coloration. To help identify the cause, a person with sclera icterus will require proper testing for liver enzymes. In newborns sclera icterus occurs because their liver hasn’t matured. Scleral icterus manifests with symptoms like yellowing of an individual’s eye part that is usually white, and it can indicate a dysfunctional liver. When an individual has yellow eyes, he or she is thought to have a problem with their liver like liver disease.

Positive scleral icterus