Blue Sclera

Blue Sclera

The below video snippet is a case of blue sclera. Blue sclera isn’t really blue but can be from either thinning of the sclera which causes a bluish hue on examination or pigmentation deposits that can also appear to give a bluish hue to the sclera.



Blue sclera can be a sign of systemic disease such as collagen synthesis disease (Ehlers-Danlos syndrome, osteogenesis imperfecta and, occasionally, Marfan’s syndrom).  Collagen synthesis diseases cause congenital defects in collagen synthesis that results in thinning of the sclera.  However, blue sclera can also be from pigmentation deposits associated with systemic diseases including Alkaptonuria, Primary adrenal insufficiency (Addison’s disease) , or by autoimmune destruction of the adrenal glands.

Systemic medicines such as minocycline can also cause blue sclera as is the answer in this case.  Other medicines that can cause this include amiodarone, phenothiazines, antimalarial agents, and long-term use of prednisone. Finally, topical medications such as epinephrine-containing eye drops can lead to pigmented deposits and exposure to soluble silver compounds (argyrosis).

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