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Ophthalmology and Visual Sciences



Category(ies): Cornea, External Eye Disease
Contributor: Zachary Q. Mortensen, MD
Photographer: Zachary Q. Mortensen, MD

The image shows conjunctival icterus in a 49-year-old Hispanic female with decompensated alcoholic cirrhosis with severe alcoholic hepatitis. Bilirubin level is at 30 mg/dL (normal limit <=1.2 mg/dL). In addition to the yellowed conjunctiva, note the surrounding jaundiced skin. The yellow hue is better appreciated when seen in natural light and when juxtaposed with the white paper and/or the examiner's finger. The deposits of bilirubin are contained in the conjunctiva, and the color is accentuated by the white scleral background. Thus "scleral icterus" is technically an incorrect term.

  1. Tripathi RC and Sidrys LA. (1979). 'Conjunctival icterus,'not'scleral icterus'. JAMA, 242(23), 2558-2558.
  2. Manning MH, Rustgi AK, Chamberlain SH, Marcus DM. Gastrointestinal and Nutritional Disorders. In: Mannis MJ, Holland EJ (eds), Cornea, 4th edition. Elsevier. (2017) Chapter 332, 4535-4546

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Ophthalmic Atlas Images by, The University of Iowa are licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 3.0 Unported License.