Description of Corneal Arcus (Arcus Senilis)
Corneal Arcus, sometimes referred to as Arcus Senilis in an older patient, is a greyish or yellowish opaque colored ring or arc around the peripheral cornea of both eyes. The corneal arcus ring consists of lipid/cholesterol deposits in the periphery of the cornea stromal layer. The lipid deposits (corneal arcus) typically start at 6 & 12 o’ clock on the cornea, but can eventually fill in to create a full ring. Arcus Senilis does not create any type of problem with vision. Corneal arcus is not considered much of a problem in the older population; however, in patients 40 and younger there is a chance the patient has elevated blood lipid levels. When found in a younger patient the condition is often called arcus juvenilis.
Cause of Corneal Arcus
Corneal arcus (arcus senilis) is common in older patients as a fairly common age-related change and as previously stated is often then called arcus senilis. Many people develop the condition if they live long enough. Corneal arcus has been somewhat controversial over the years regarding its link to cardiovascular disease due to high lipid/cholesterol levels. In recent years, the National Institute of Health concluded that “corneal arcus reflects widespread tissue lipid deposition and is correlated with both calcific atherosclerosis and xanthomatosis* in these patients. Patients with more severe arcus tend to have more severe calcific atherosclerosis”. However, other studies have shown no correlation to cardiovascular disease.
Signs/Symptoms of Corneal Arcus
The signs of corneal arcus are a visible greyish ring around the cornea near the junction of the white of the eye and the colored iris. Although the arc/ring can be seen by the naked eye with careful observation, it is best seen under high magnification by your eye doctor.
Corneal arcus is asymptomatic. Quite simply the eye feels fine. In fact, if there are symptoms they are not related to corneal arcus.
Treatment/Management of Corneal Arcus (Arcus Senilis)
If corneal arcus is found in patients over the age of 40, no management is needed. However, it is recommended that the patient get blood tests to determine cholesterol and lipid levels if not known.
If corneal arcus is found in a patient younger than 40 (often arcus juvenilis), blood tests are definitely recommended to rule out lipid and cholesterol abnormalities. Studies show that male patients less than 40 who present with corneal arcus, have an increased relative risk of death due to coronary artery or cardiovascular disease.
Unilateral corneal arcus is a sign of decreased blood flow to the eye without the arcus due to carotid artery disease or ocular hypotony.
*Xanthomatosis is defined by Mosby's Medical Dictionary as "an abnormal condition in which there are deposits of yellowish fatty material in the skin, internal organs, and reticuloendothelial system".