![]() Previous suggestions that staining occurs in the conjunctiva, and not the sclera, due to elastin content are not supported anatomically. Scleral icterus is more accurately termed conjunctival icterus, as this is where the majority of bilirubin staining is seen on unstained histology. 1 Unilateral conjunctival icterus of the right eye. There was no ocular prosthesis in this case, thus provoking our earnest consideration. In this case, we noticed on a ward round 5 days after admission that a 42‐year‐old male alcoholic patient had unilateral icterus ( Fig. ![]() We were prompted by this Journal's recent publication showing unilateral scleral icterus in a patient with a ‘glass eye’, putatively explained by hepatic metastases from a previous choroidal melanoma. ![]() It has also been reported as being due to hyperbilirubinaemia in a monocular patient (in It is more commonly seen in resolving unilateral subconjunctival haemorrhage, although in this setting, it would not normally be labelled as icterus. Unilateral conjunctival icterus is a relatively rare clinical finding in the setting of jaundice. It is possible that the increased level of bilirubin in the extracellular fluid from the inflammatory exudates explains these changes. ![]() Unilateral conjunctival icterus and no ‘glass eye’ Unilateral conjunctival icterus and no ‘glass eye’ ![]()
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