Next time you look in the mirror, make it a point to gaze deeply into your own eyes and take careful note of what you see. Is there a ring around your irises? Is there variation from one eye to the other? Are the whites of your eyes bright white, cloudy or on the yellow side? The answers to these questions might provide some important insights into the state of your health. I consulted Richard S. Koplin, MD, a board-certified ophthalmologist and director of the Cataract Division of the New York Eye and Ear Infirmary in New York City, for his take on when these variations are worrisome.

Keep an Eye Out for Trouble

Most people don’t realize that many disorders, both eye-related and systemic, can be reflected in color changes in the eyes. Some alterations take place in the white of the eye (the sclera)… others in the conjunctiva, the clear layer of tissue that covers the sclera … and yet others in the iris, the pigmented part of the eye surrounding the pupil. Dr. Koplin outlined a number of eye abnormalities and what they might mean for your health…

  • A sudden red spot in the white of the eye is generally what’s known as a subconjunctival hemorrhage, caused by a brief elevation in blood pressure above the neck. This only sounds ominous — Dr. Koplin said it’s no cause for worry, and it should fade within 36 hours. It can happen as a result of sneezing… straining (such as to lift a heavy object)… trauma (particularly to the head)… or from taking aspirin or blood thinners. Caveat: If this happens for absolutely no reason and most especially if it recurs, check with your doctor.
  • Yellowish eyes. A yellowish tinge to the white part of your eyes can be a sign of liver or gallbladder disease, most especially if you feel abdominal bloating (particularly on the right side)… experience gassiness… or notice that your stools are unusually pale. Schedule a doctor’s visit.
  • Muddy eyes. African Americans, as well as some other darkly pigmented individuals, may notice that the whites of the eyes darken and grow cloudy with age. This is a normal change in pigmentation associated with age, Dr. Koplin said. No treatment is necessary.
  • A gray white ring around the iris (appearing on the iris but actually on the periphery of the cornea). Not particularly uncommon in middle-aged and older individuals, this is a type of fat deposit that can occur with age, called an arcus. It’s not a cause for concern.
  • Changes in iris pigmentation. Some people are born with eyes of different color (a condition called heterochromia), but if it develops later in life it can be related to chronic inflammation (iritis) and require treatment. A change in eye color can sometimes occur as a side effect of medications used in or near the eyes — for example, glaucoma eye drops called prostaglandin analogues (such as Latisse, a drug for lengthening and thickening eyelashes) can darken the iris. If you detect any change in eye color, stop the medication and consult an ophthalmologist.
  • A whitish discoloration of the central pupil. This is a sign of a very mature cataract, Dr. Koplin said, adding that it is almost never seen here in the US, where people get treatment for vision problems.
  • A sudden spot of color or darkening of the iris. An inexplicable and sudden change in the color of one area of one of your irises requires a visit to an ophthalmologist — it can be a sign of a tumor.

Don’t Make Your Brown Eyes Blue!

Beware of practitioners peddling surgical procedures to change eye color. Dr. Koplin told me that he has treated patients who traveled to South America for expensive implants of colored discs to change eye color (a procedure that is not approved in the US). The discs caused problems such as irritation, inflammation, glaucoma and cataracts and required emergency surgical removal. If you must have a change, look into colored contacts instead!