Corneal icterus resulting from stromal bilirubin deposition

Three pairs of donor corneas were noted to be stained yellow after dissection from the whole globe. The peripheral cornea was stained more intensely than the central cornea in each case. All three of the donors had had jaundice with elevated serum bilirubin levels for at least 1 month before death. The corneas were finely minced and eluted in chloroform for a period of at least 1 week. Scleras from two of the three donors were similarly treated. Spectrophotometric analysis of the corneal and scleral eluates demonstrated the absorbance spectrum of bilirubin (400-490 nm). Identically prepared eluates of normal corneas and scleras from three donors did not show the absorbance spectrum of bilirubin. Results of slit-lamp examination of both eyes of a severely jaundiced patient disclosed yellow pigmentation of the corneal stroma with the peripheral cornea showing more pigmentation than the central cornea. Corneal bilirubin deposition, a previously undescribed finding, may occur in patients with jaundice.