Arcus senilis is a ring of cholesterol deposits in the cornea that increases with age and is more common in men. It can indicate high cholesterol levels and may be a sign of reduced blood flow to one eye or a symptom of Sturge-Weber syndrome. Young people with arcus senilis may have a family history of high cholesterol and early heart disease.
Arcus senilis is an opaque grayish blue to white band in the periphery of the cornea, which is the transparent window-like structure on the front of the eye. The number of people with arcus senilis increases with age for both genders, with the problem occurring more frequently in men than in women. Cholesterol crystals, or fats, are deposited in the central layer of the cornea, fusing into the ring structure. Arcus deposits appear initially at the six and twelve o’clock positions of the cornea and expand circumferentially to form the entire ring. A thin, clear area between the ring and the corneal edge is called the lucid interval of Vogt.
More than two thirds of men and women in the eighth decade of life have this condition. Women rarely develop arcus before menopause. The condition is more common in patients of African descent than in Caucasians. Also, the corneal arch is often present in smokers, hypertensive patients and diabetics.
Although arcus can occur in the absence of any medical conditions, the presence of arcus senilis can be an indicator of high cholesterol or high blood lipid levels. In most patients with corneal arch over the age of 40, blood cholesterol levels are normal. If an individual under the age of 40 has arcus senilis, it is more likely to indicate high cholesterol levels. Young people with this condition usually have a significant family history of high cholesterol and early heart disease. Arcus in a juvenile is called arcus juvenilis.
When arcus senilis affects only one eye, it can be a sign of reduced blood flow to the unaffected eye. This may be indicative of blockage or calcification of a carotid artery. Sturge-Weber syndrome, a condition associated with unilateral facial port-wine stain and increased eye pressure, can also lead to the development of a unilateral arch on the unaffected side. Scientists hypothesize that the tumor of the facial blood vessels increases the pressure in the eye, thereby decreasing blood flow through the eye. Decreased blood flow from carotid artery occlusion or Sturge-Weber has a protective effect against cholesterol deposition in the cornea.
The finding of arcus senilis in patients younger than 40 requires a prompt blood test to evaluate the possibility of lipid abnormalities in the body. Other signs and symptoms of abnormally high blood lipids include fatty deposits on the eyelids, called xanthelasma, and fatty deposits in the skin, called xanthomas. The condition, while usually asymptomatic, can also cause chest pain, abdominal pain, and enlarged spleen and liver.
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