Definition of Scleral Icterus

Scleral icterus, a condition characterized by the yellowing of the eyes, is often mistakenly associated with increased bilirubin levels in the blood. However, this is not always the case, as demonstrated by recent research. In fact, the lipophilic nature of carotenoids means that even small amounts can remain in tissues for up to five months, resulting in discoloration.

The majority of cases presenting with scleral icterus are acute and self-limiting, accompanied by symptoms such as fever, myalgia, headache, nausea, anorexia, and abdominal pain. In some instances, the condition may be caused by a tropical disease, such as hypercarotenemia, which is the most common zoonotic illness worldwide.

For example, a recent study found that a patient who had consumed large quantities of red palm oil while living in Liberia presented with scleral icterus due to the ingestion of this carotene-rich food source. The condition was verified by a serum beta-carotene level slightly above normal.

In contrast, bilirubin does not accumulate in the sclerae, and an increase in bilirubin levels can only cause yellowing of the eyes in certain medical conditions. Therefore, it is essential to consider other possible causes of yellow-orange discoloration of the skin, including hypercarotenemia, lycopenemia, and riboflavinemia.

In conclusion, scleral icterus is a condition characterized by the yellowing of the eyes, which can be caused by various factors. It is important to ascertain the presence or absence of scleral icterus in determining the diagnosis, as there are many possible causes of yellow-orange discoloration of the skin.

Definition scleral icterus