Icterus. When red blood cells break down they release bilirubin. This bilirubin is filtered out by the body's coffee filter, the liver. If the liver is not working well or too many red blood cells are breaking down (as with sickle cell), the bilirubin builds up and turns the skin and whites if the eyes yellow. This yellow discoloration is easier seen in the eyes since there is no pigment for masking, .