There are a few potential reasons why someone’s iris (the colored part of the eye) may turn white or become paler over time. The iris contains pigment which determines eye color. A change in this pigment sometimes occurs with age or due to certain medical conditions. Understanding the possible causes can help determine if treatment is needed.
Aging Process
As we age, the pigment in the iris can start to fade and deplete over time. The cells that produce melanin (the pigment that gives the iris its color) gradually lose function and die off. As a result, the iris may turn from a darker color in youth to a lighter, muted shade by the time a person reaches old age. This process also causes the appearance of age-related spots and cloudiness in the eye. The aging of iris pigment is a normal change that eventually happens to everyone.
Medical Conditions That Can Cause Changes
Certain medical disorders can also bring about de-pigmentation or whitening of the colored part of the eye. These include:
– Fuchs’ heterochromic iridocyclitis: This is a rare eye disease involving inflammation that usually only affects one eye. It causes the iris to change color over time, often becoming lighter on the affected side.
– Horner’s syndrome: This condition damages the sympathetic nerves which control pupil size and iris function. It leads to constriction of pupils and sometimes loss of color in one iris.
– Pigment dispersion syndrome: With this disorder, pigment granules from the iris rub off and are deposited in other areas of the eye. This results in a gradual depletion of iris color.
– Choroidal melanoma: This form of eye cancer affecting the choroid layer at the back of the eye can cause secondary changes to the iris and de-pigmentation as the tumor grows.
– Ocular albinism: A genetic disorder which interferes with the production and distribution of melanin in the eyes. This can make the irises appear very light blue, gray, or brown.
– Trauma/injury: Damage to the eyes from an accident or injury may result in a loss of pigmentation in the iris. The affected iris can turn white or pale.
– Medications: Certain glaucoma and epilepsy medications like phenothiazines have been associated with a risk of iris discoloration and depigmentation over time.
Is the Color Change Permanent?
In many cases, a change in iris color due to aging or medical issues is permanent and cannot be reversed. The loss of pigment cells and melanin is often progressive and leads to continual lightening over time. However, in some instances, the pigmentation can be restored:
– If the depigmentation is caused by inflammation from an underlying condition like iridocyclitis, treating the source inflammation may allow the iris to regain some color once the episode has resolved.
– Changing or stopping causative medications which are associated with iris discoloration could potentially allow the pigment to return. However, this may not always be possible if the medication is necessary.
– Ocular trauma that damages the iris can sometimes be repaired through surgery, allowing pigmentation to be restored.
– With ocular albinism, the color lightening is present from birth and remains stable rather than getting worse over time.
In general, changes to the iris related to aging are irreversible. But identifying and addressing underlying medical causes could improve pigmentation in some cases.
Is the Color Change Harmful?
Aside from cosmetic concerns about change in eye appearance, a loss of iris pigment is typically not harmful on its own. The whitening does not normally affect vision or eye health. Exceptions when discoloration could indicate an underlying problem include:
– If the color change is sudden, asymmetric (only in one eye) or accompanied by other symptoms like eye pain or light sensitivity, it is more likely to be related to a medical disorder and should be evaluated.
– Depigmentation caused by cancer warrants immediate medical attention to treat the underlying malignancy.
– Complete loss of color in both irises could potentially be associated with vision loss or blindness if it is indicative of ocular albinism or other diseases involving lack of pigment in the eyes.
As long as there are no worrisome symptoms or substantial vision changes, a gradual lightening of iris color with age is not considered detrimental to the eyes. The appearance may be unsightly but does not typically impair function. However, prompt examination is recommended if the discoloration is sudden, uneven between eyes or accompanied by other problems.
Preventing Further Color Change
It is difficult to prevent or slow age-related loss of iris pigmentation. However, the following healthy habits can help maintain eye health and potentially delay changes:
– Wearing UV-blocking sunglasses outdoors to minimize sun damage to the eyes.
– Quitting smoking, as tobacco use is linked to faster depletion of pigment.
– Controlling other ocular risk factors like high eye pressure or diabetes which can accelerate pigment changes.
– Regular eye exams to monitor the eyes for any concerns and promptly treat medical conditions related to iris discoloration.
While some paling of the iris is inevitable with aging, protecting the eyes from excess UV light exposure, maintaining systemic health, and getting routine eye care can help preserve their function and appearance. If pigment changes seem abnormal, prompt medical evaluation is key.
Treatment Options
Unfortunately, there are no proven treatments capable of restoring iris pigmentation that has been lost due to aging or medical problems. However, some cosmetic options to change the appearance of lightened eyes include:
– Tinted contact lenses: Opaque colored contacts can cover up an underlying pale iris. These must be properly fitted by an eye doctor.
– Iris implants: Surgical implantation of a colored artificial iris. This involves risk of complications.
– Tattooing: Injecting natural pigments into the areas of iris depigmentation to darken them. This has variable effectiveness and the long-term safety is unknown.
– Laser treatment: Low-level light therapy is sometimes attempted to stimulate melanin production, but results are inconclusive.
None of these iris re-pigmentation techniques are consistently effective and they carry risks of side effects. That’s why they are not routinely recommended. It’s generally best to accept the age-related color change. Consulting an ophthalmologist for advice based on the individual situation is suggested.
What to Expect
For most people, pale or white irises as a consequence of aging do not pose any threat to vision. While the change may be undesirable from an aesthetic standpoint, it is a normal part of growing older. The pigment decline is gradual and irreversible. With healthy habits and regular eye exams, complications are unlikely.
If whitening of the iris arises due to a medical disorder, the prognosis depends on the underlying cause:
– Inflammation-related depigmentation often stabilizes and does not worsen once the inflammatory episode resolves and is properly managed.
– Loss of color from medications, injury or diseases like glaucoma has a better outlook if these triggers can be controlled or avoided.
– Cancer-associated discoloration has a more uncertain prognosis tied to the tumor progression and response to treatment.
– Congenital albinism involving complete lack of iris pigment remains static and does not typically impact vision with the right eye care.
With age-related lightening of the iris being common and benign in most cases, learning to adjust to the cosmetic change is often the healthiest approach. Staying attuned to any worrisome symptoms concurrent with the color change is prudent.
Conclusion
A number of factors can lead to the iris becoming less pigmented and lighter over time. In many cases, it is simply an inevitable part of the aging process that does not affect eye health. But sometimes certain medical conditions or ocular diseases are at play. Sudden onset of discoloration or other accompanying symptoms warrant an examination to identify possible underlying causes. While re-pigmentation therapies exist, they have limited effectiveness and risks. Learning to accept the natural color evolution of the eyes is often the safest path. Staying vigilant about eye health through regular screenings can help ensure that any problematic reasons for iris discoloration are caught early. With proper care, the change in shade is usually just an innocuous sign of growing older.
