Normal Age-Related Sclera Changes
As the body ages, so do the eyes, and changes to the sclera (the white part of the eye) are a common occurrence. The bright, white appearance of a child's eyes typically fades over time, becoming duller, yellower, or spotted. This shift is not usually a cause for alarm but is a natural result of cumulative lifetime exposure and physiological changes.
Thinning of the Conjunctiva
Over decades, the conjunctiva—the thin, clear membrane covering the sclera—can lose its translucency and become thicker. This allows the underlying blood vessels and other structures to show through more prominently, which can make the eyes appear less vividly white. The change contributes to an overall duller appearance.
Lipid Deposits
With age, harmless lipid (fatty) deposits can accumulate between the collagen fibers of the sclera. This accumulation can cause a yellowing effect, especially when combined with a thinning conjunctiva. In addition, a gray or white arc known as arcus senilis may form around the iris, also due to lipid accumulation, but this does not affect vision.
Cumulative Sun Exposure
Decades of sun exposure without proper protection can take a significant toll on eye health and appearance. Just as the sun affects skin, UV radiation can damage the elastic fibers in the conjunctiva, causing them to change color and appear yellowish. Wearing UV-blocking sunglasses is crucial for protecting the eyes from this long-term damage.
Benign Growths: Pinguecula and Pterygium
Another common cause of yellowish or reddish spots on the whites of the eyes are growths that form on the conjunctiva.
- Pinguecula: A pinguecula is a small, yellowish bump or patch that bulges out of the conjunctiva, usually on the side of the eye closer to the nose. These are most commonly caused by exposure to sun, wind, and dust over a prolonged period. They can become inflamed and appear reddish.
- Pterygium: A pterygium, sometimes called “surfer's eye,” is a larger, more concerning growth that can develop from a pinguecula. It is a wedge-shaped growth of fleshy tissue that starts on the sclera and can extend onto the cornea, potentially obstructing vision. Surgery is sometimes required if it becomes too large.
When Discoloration Signals a Health Problem
While most scleral discoloration is benign, certain colors or symptoms can indicate a more serious underlying health issue that requires medical attention. It is crucial to distinguish between normal aging and a medical condition.
Jaundice and Liver Issues
If the entire sclera takes on a yellowish or light greenish hue, it could be a sign of jaundice, a condition that results from an accumulation of bilirubin in the blood. Bilirubin is a compound the body produces when it breaks down old red blood cells, and a healthy liver typically filters it out. When the liver, gallbladder, or pancreas is not functioning correctly due to disease or other issues, bilirubin can build up and cause the yellowing of both the eyes and the skin.
Redness and Inflammation
Redness in the eye can be caused by simple fatigue, allergies, or irritation from things like smoke or contact lenses. However, bloodshot eyes can also indicate more serious conditions like infections (conjunctivitis), uveitis, or glaucoma. If redness is accompanied by pain, blurred vision, or discharge, see an eye doctor immediately.
Other Causes for Tinting
In rarer cases, a bluish-grey tint to the sclera can indicate a systemic issue. This can happen with certain long-term medications, or with genetic conditions that cause the sclera to be thinner than usual, allowing the underlying choroid tissue to show through.
Benign vs. Serious Eye Discoloration
| Feature | Benign Age-Related Change | Potentially Serious Condition |
|---|---|---|
| Appearance | Mild, generalized yellowing or dullness; small, yellowish spots (pinguecula). | Deep, widespread yellowing (jaundice); bright red blood spot (hemorrhage); persistent bloodshot eyes. |
| Onset | Gradual, occurs over many years as part of the aging process. | Can be sudden, especially for jaundice or infections. |
| Accompanying Symptoms | May include dryness or irritation, especially with growths. | Can include fatigue, abdominal pain (jaundice), blurred vision, pain, discharge, light sensitivity, or swelling. |
| Cause | Thinning tissue, lipid deposits, cumulative sun damage, wind/dust exposure. | Liver, gallbladder, or pancreas disease; infections; autoimmune disorders; chronic diseases. |
What You Can Do About Age-Related Eye Color Changes
- Protect Your Eyes from the Sun: Wearing 100% UVA and UVB blocking sunglasses and a wide-brimmed hat outdoors is the most effective way to prevent cumulative UV damage.
- Maintain a Healthy Diet: Eating a diet rich in fruits, vegetables, leafy greens, and omega-3 fatty acids supports overall eye and liver health.
- Stay Hydrated: Drinking plenty of water helps your body function optimally, including maintaining proper tear production to combat dry eye irritation.
- Avoid Irritants: Limiting exposure to smoke, dust, and other environmental irritants can reduce redness and swelling.
The Importance of Regular Eye Exams
Regular comprehensive eye exams are the best way to monitor your eye health and catch any developing problems early. An eye doctor can differentiate between benign age-related changes and more serious conditions. It is especially important to have a dilated eye exam annually after age 60, or sooner if you have chronic conditions like diabetes or a family history of eye disease. For more information on senior eye health, consult the recommendations from the National Eye Institute.
Conclusion
While it is normal for the whites of your eyes to lose some of their youthful brightness and develop a yellowish or reddish tint with age, it is important to pay attention to any sudden or significant changes. Age-related yellowing is often harmless, but if accompanied by other symptoms or if the entire sclera turns noticeably yellow, it can be a sign of a more serious health issue. Being proactive with sun protection, a healthy lifestyle, and regular eye doctor visits will help you maintain healthy, bright eyes for years to come.
