Arcus Senilis – What Does It Indicate?

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Arcus senilis, also known as corneal arcus, is a white, light grey or blueish arc or circle that develops around the edge of the cornea. It typically starts as an arc below and above the cornea but can grow, forming a complete ring. This arc is formed from fatty deposits (mostly cholesterol) known as lipids.

Arcus senilis is common among middle aged people, and almost everyone will get it as they age. If these rings begin to appear around middle age or later, there is usually nothing to worry about. However, if found in children, these arc-like rings can indicate high cholesterol.

Who is likely to get arcus senilis?

Older adults are more likely to get arcus senilis, especially if there is a family history of high cholesterol. Nevertheless, arcus senilis at middle age or later in life does not necessarily indicate high cholesterol. It is more common in men and African Americans. However, as people age, most are likely to get arcus senilis.

Does arcus senilis affect vision?

Arcus senilis does not affect vision or require treatment. However, it causes the discolouration of the cornea, which can make it appear as though the iris is two different colours.

In rare cases, children are born with arcus senilis. Rings that appear around the iris in childhood or young adulthood are referred to as arcus juvenilis. This can be a sign of health problems, including high cholesterol and should be seen by an ophthalmologist.

Causes of arcus senilis

Arcus senilis is caused by fat deposits (lipids) including Cholesterol, triglycerides, and phospholipids. These fats come from the food we eat and are also produced by the liver. Our liver produces all the cholesterol needed by our bodies to make hormones and vitamins and build cells. Too much cholesterol; however, can increase the risk of cardiovascular disease.

When we age, our blood vessels widen allowing more fats including cholesterol to enter the eye. Arcus senilis does not necessarily mean that one has high cholesterol.

Is arcus senilis serious?

Arcus senilis is not serious unless it signifies high cholesterol. High cholesterol can cause serious health issues, including cardiovascular disease and coronary artery disease. Arcus senilis is not dangerous; however, high cholesterol can be.

Diagnosing arcus senilis

Your eye care professional/optician will be able to diagnose arcus senilis and may use a slit lamp test to examine your eyes.

They may also dilate your pupils during this exam using special eye drops. This can allow them to look at the blood vessels in the back of your eye for signs of eye disease. They will also examine the thickness of the blood vessels, checking for fat deposits.

If necessary, they may refer you to an ophthalmologist for further testing.

If you are under the age of 40 and present signs of arcus senilis, you may be referred for blood tests, which can check your cholesterol and lipid levels.

Treatment of arcus senilis

If arcus senilis is a sign of high cholesterol, treatment may involve medication and lifestyle changes to lower the level of cholesterol in your blood. Lifestyle changes can include:

Following a healthy diet – taking care to limit your intake of saturated fats and trans fats and making sure you eat foods high in soluble fibre such as apples and brussels sprouts
Exercising regularly – increasing your uptake of exercise and making it a regular habit can increase your good cholesterol levels. Just make sure you do this with your doctor’s advice
Cutting down on alcohol - consuming too much alcohol can lead to a higher risk of heart failure, strokes, as well as other health issues
Stopping smoking - this can improve your cholesterol level

Changing your diet and physical activity is not always enough for some people to lower their cholesterol. However, there are certain medications that can be prescribed in these instances.

Does arcus senilis go away?

Arcus senilis does not go away. It will neither fade nor disappear. However, it will not cause you blindness or any other vision problems and is often nothing to worry about unless it appears in younger people, in which case, it can be related to high cholesterol levels.