Arcus senilis

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Arcus Senilis[edit | edit source]

Corneal arcus

Arcus senilis is a common ophthalmological condition characterized by a gray or white arc or ring around the cornea of the eye. This condition is often associated with aging and is considered a normal finding in older adults. It is also known as corneal arcus or arcus lipoides.

Pathophysiology[edit | edit source]

Arcus senilis occurs due to the deposition of lipids in the peripheral cornea. These lipids are primarily cholesterol and phospholipids, which accumulate in the corneal stroma. The condition is typically bilateral, meaning it affects both eyes, and the arc or ring is usually located at the corneal periphery, sparing the central cornea.

Clinical Presentation[edit | edit source]

Four representative slides of corneal arcus

Arcus senilis appears as a white, gray, or blue opaque ring in the corneal margin. It is more common in older adults, typically appearing after the age of 50. In younger individuals, the presence of arcus senilis may indicate hyperlipidemia or other lipid metabolism disorders.

Diagnosis[edit | edit source]

The diagnosis of arcus senilis is primarily clinical, based on the characteristic appearance of the corneal ring. An ophthalmologist can easily identify the condition during a routine eye examination using a slit lamp.

Significance[edit | edit source]

While arcus senilis is generally considered a benign condition in the elderly, its presence in younger individuals may warrant further investigation for underlying lipid disorders. In such cases, a lipid profile test may be recommended to assess cholesterol levels and evaluate the risk of cardiovascular disease.

Management[edit | edit source]

Arcus senilis itself does not require treatment, as it does not affect vision or cause any symptoms. However, if it is associated with hyperlipidemia, managing the underlying lipid disorder is important to reduce cardiovascular risk.

Related Conditions[edit | edit source]

Arcus senilis should be differentiated from other corneal opacities and rings, such as Kayser-Fleischer ring, which is associated with Wilson's disease.

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Contributors: Prab R. Tumpati, MD