Ruiz MA, Saab S, Rickman LS. The clinical detection of scleral icterus: observations of multiple examiners. Mil Med. 1997 Aug;162(8):560-3. No online full-text.
Objective: Assess physicians’ detection of sclera icterus in patients with elevated bilirubin.
Methods: 62 observers at various level of training evaluated 6 patients (ethnicity unknown) with elevated bilirubin for sclera icterus.
Data: 58% of examiners detected scleral icterus in patients with total serum bilirubin of 2.5 mg/dl
68% of examiners detected sclera icterus in patients with total serum bilirubin of 3.1 mg/dl