Blue sclera: what it is, symptoms, causes and what to do

Blue sclera: what it is, symptoms, causes and what to do


Blue sclera is the bluish coloration of the white part of the eyes, and is generally caused by congenital or hereditary diseases, such as osteogenesis imperfecta or Ehlers-Danlos syndrome, which make the sclera thinner, which ends up leaving the blood vessels and the uvea more visible, giving the sclera a blue hue.

However, blue sclera can also appear throughout life due to iron deficiency anemia, hyperhomocysteinemia or even the use of medications, such as amiodarone or minocycline, for example, causing thinning of the sclera.

The treatment of blue sclera is carried out by a general practitioner, pediatrician, hematologist or orthopedist, and varies according to the cause and severity of the disease, and changes in diet, use of medication or physiotherapy may be indicated, for example.

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Blue sclera symptoms

The main symptom of blue sclera is the blue color of the white part of the eye, which in some cases can be grayish-blue or purple-blue.

Additionally, depending on its cause, blue sclera can affect one or both eyes.

Don’t ignore your symptoms!

Possible causes

The main causes of blue sclera are:

1. Iron deficiency anemia

Iron deficiency anemia is caused by iron deficiency, which is important for producing hemoglobin and forming red blood cells, which are cells that transport oxygen to the body’s tissues.

Thus, the reduction of oxygen, especially in the brain, can result in weakness, headache, changes in menstruation, excessive tiredness and can even lead to the appearance of blue sclera. Know how to identify all the symptoms of iron deficiency anemia.

What to do: the treatment of iron deficiency anemia must be carried out according to the guidance of the hematologist and normally includes the use of iron supplements, in addition to the consumption of foods rich in iron such as lentils, parsley, beans and red meat, for example. example. See how to make a diet rich in iron.

2. Osteogenesis imperfecta

Osteogenesis imperfecta is a congenital disease that causes bone fragility due to some genetic changes associated with type 1 collagen.

The symptoms of this disease, also known as brittle bone disease, begin to appear in childhood, one of the symptoms being the presence of blue sclera, in addition to bone deformities in the skull and spine, as well as laxity in the bone ligaments. Know all the symptoms of osteogenesis imperfecta.

What to do: You should consult your pediatrician or orthopedist to begin the most appropriate treatment, which may involve the use of bisphosphonate medications to strengthen bones and physiotherapy.

3. Marfan Syndrome

Marfan syndrome is a rare hereditary disease caused by a mutation in the fibrillin-1 gene, responsible for producing important proteins for the functioning of the heart, eyes, muscles and bones.

This syndrome causes ocular symptoms, such as blue sclera, retinal displacement, glaucoma or cataracts, for example, in addition to changes in the bones, a spine that is more curved to one side or heart changes, for example.

What to do: The diagnosis of this syndrome can be made during pregnancy, however, if it is suspected after birth, the pediatrician may recommend genetic tests and blood or imaging tests to check which parts of the body the syndrome has affected. As Marfan syndrome has no cure, treatment is based on controlling changes in the organs.

For families who have cases of this syndrome, it is recommended to undergo genetic counseling, in which the genes will be analyzed and a team of professionals will provide guidance regarding treatment. Find out more about what genetic counseling is and how it is done.

4. Ehlers-Danlos Syndrome

Ehlers-Danlos syndrome is a set of hereditary diseases characterized by a defect in collagen production, leading to elasticity of the skin and joints, as well as problems supporting the walls of arteries and blood vessels.

The symptoms of this syndrome vary, with body dislocations, muscle bruises and skin on the nose and lips thinner than normal, making injuries more likely to occur.

What to do: The treatment is carried out by doctors from various specialties, such as a cardiologist, ophthalmologist, dermatologist or rheumatologist, so that the best treatment is indicated according to the affected organ. See how Ehlers-Danlos syndrome is treated.

5. Use of medications

Some medications, such as minocycline or prednisone, can also lead to blue sclera.

Mitoxantrone is another medication that can cause blue sclera, in addition to causing depigmentation of the nails, leaving them grayish in color. This medicine is indicated for the treatment of breast cancer, leukemia or lymphoma, for example.

What to do: These situations are very rare, however, if a person is taking any of these medications and observes that the white part of the eye has a bluish color, it is important to notify the doctor who prescribed the medication, so that suspension, change in dose or switching to another medication. Under no circumstances should you interrupt treatment and use of the medicine on your own.

6. Hyper-homocysteinemia

Hyperhomocysteinemia is an increase in homocysteine ​​in the blood, an amino acid that participates in cell metabolism and protein synthesis, and is caused by a diet rich in proteins, especially red meat, low levels of thyroid hormones, or low intake of foods with vitamin B6, B12 or folic acid.

When its levels are high in the blood, homocysteine ​​can cause blue sclera, in addition to increasing the risk of pulmonary embolism, stroke or heart attack.

What to do: The treatment of hyperhomocysteinemia is carried out by a general practitioner or cardiologist, and usually involves changes in diet or dietary supplements, and it is important to maintain regular medical monitoring to assess homocysteine ​​levels in the blood and avoid cardiovascular diseases. See how the test is carried out to measure homocysteine ​​in the blood.