Xanthopsia is a visual disturbance where everything in a person’s field of view appears tinted with yellow. It is a symptom, not a disease, indicating an underlying medical issue or exposure to certain substances. This phenomenon is a form of acquired color vision deficiency, and identifying its source is necessary for proper treatment.
Defining the Condition
A person experiencing xanthopsia perceives the entire visual environment, including objects that should be white or blue, as being abnormally yellowish or golden. This alteration in color perception can range from a subtle yellow hue to a more intense, saturated yellow tint. Xanthopsia is classified as a type of chromatopsia, the general term for a visual condition where objects are seen with an unnatural color tint.
The visual distortion results from a disruption within the visual system, which can occur at several points, including the lens, the retina, or the visual pathways leading to the brain. This is distinct from the physical yellowing of the skin and whites of the eyes (sclera) seen in jaundice. While high levels of bilirubin from jaundice can sometimes cause xanthopsia by depositing pigment within the eye’s fluids, the condition itself is a change in perception.
Primary Medical Causes
One of the most common physical causes of xanthopsia is the development of a severe cataract, specifically nuclear cataracts, where the eye’s lens gradually becomes cloudy and takes on a yellow-brown discoloration. This discolored lens acts as a physical filter, preferentially blocking shorter, blue wavelengths of light from reaching the retina. The remaining light that passes through is skewed toward the longer, yellow wavelengths, causing a yellow tint to vision.
Systemic health problems can also manifest as yellow vision, particularly conditions affecting the liver. Jaundice, or hyperbilirubinemia, results from excessive bilirubin in the blood, and while it primarily stains tissues, the pigment can rarely accumulate within the ocular media to a degree that affects light transmission. Additionally, diseases that damage the small blood vessels of the eye, such as advanced diabetic retinopathy or age-related macular degeneration, can alter the function of the retina’s photoreceptor or ganglion cells, leading to color perception changes like xanthopsia.
Drug-Induced Xanthopsia
Medication toxicity is a significant and well-documented cause of yellow vision, often reversible upon discontinuation of the drug. The most famous example is Digitalis, a class of medications used for certain heart conditions, with the compound Digoxin being the most common culprit. Digoxin toxicity can cause xanthopsia through its inhibitory action on the sodium-potassium pump (Na+/K+-ATPase) found in the retina’s photoreceptor cells, which disrupts the electrical signaling necessary for color vision.
Other drug classes are also known to induce this side effect, including certain antibiotics, anti-malarial drugs like quinine, and phenothiazines (antipsychotics). Medications used to treat erectile dysfunction, known as PDE5 inhibitors (e.g., Sildenafil), can temporarily cause a change in color perception, sometimes including a yellow-green tinge. In most cases of drug-induced xanthopsia, the visual disturbance resolves once the medication is stopped or the dosage is adjusted.
Diagnosis and Resolution
A diagnosis begins with a detailed patient history, where the physician inquires about the onset of the yellow vision, the use of prescription or over-the-counter medications, and any pre-existing medical conditions. A comprehensive eye examination is performed to check the clarity of the lens for cataracts and to assess the health of the retina, often utilizing specialized imaging techniques like Optical Coherence Tomography (OCT). Blood tests are also usually ordered to check for elevated bilirubin levels, which would indicate a liver-related cause, or to measure drug concentrations in the case of suspected medication toxicity.
Management of xanthopsia depends entirely on successfully treating the underlying cause, as there is no direct treatment for the yellow vision itself. If the symptom is caused by a medication, adjusting the dosage or discontinuing the drug often leads to resolution, while surgical removal of the cloudy lens and replacement with a clear intraocular lens is the definitive solution for severe cataracts. Individuals experiencing a sudden onset of vision changes should seek immediate medical attention.