Images of Memorable Cases: Cases 28 & 29 28 & 29. False eye with hyperbilirubinemia One patient lost her left eye (top) from trauma and now has pancreatic carcinoma. The other lost her right eye (bottom) from ocular melanoma four years earlier and now has massive hepatic metastases. Unilateral scleral icterus can appear under two circumstances: 1) the patient is jaundiced from whatever cause, and the nonicteric eye is false; or 2) the serum bilirubin is normal, and the icteric sclera reflects a resolving subconjunctival hemorrhage.