What is Arcus Senilis?
The eye is one of the most complex parts of the body and is often affected by diseases that also affect other areas of the body. In fact, sometimes eye issues can be the first sign of these diseases. One component of the eye, the cornea, is a thin, clear layer that covers the front of the eye.
Arcus senilis (also known as cornea senilis) are fat deposits that show up like rings on the edges of the cornea. They usually look gray or white and aren’t clear. They often appear thicker on the top and bottom parts of the cornea. Over time, these deposits can grow and may eventually form a ring around the entire cornea.
To diagnose corneal arcus, a doctor will visually examine the eye with a special microscope called a biomicroscope (or slit lamp). It’s important to note that sometimes corneal arcus can be mistaken for another condition called limbus sign, which involves calcium deposits in the cornea.
What Causes Arcus Senilis?
Corneal arcus, which is a formation in the eye, depends on the blood vessels in the limbus. The limbus is the border between the cornea, the clear front surface of the eye, and the sclera, the white part of the eye. This formation of arcus typically starts at the top and bottom parts of the cornea. These areas have more blood flow than the middle part of the cornea.
Areas with more blood flow also have tiny blood vessels known as capillaries that allow more substances to pass through. Current theories propose that certain fats, like cholesterol, phospholipids, triglycerides, and lipoproteins, are more likely to be transported to these areas with more blood flow.
The arcus forms when these fats spread beyond the area covered by the small vessels and then build up in the outer areas of the cornea.
Risk Factors and Frequency for Arcus Senilis
Corneal arcus, a condition that affects the eyes, has varying levels of occurrence depending on a person’s ethnic background. It’s more commonly noted in individuals of African and Southeast Asian heritage compared to those of white descent. It’s also worth noting that instances of corneal arcus tend to increase as a person gets older. For instance, nearly 100% of people above 80 years may experience this condition.
- Corneal arcus is more prevalent among individuals of African and Southeast Asian descent.
- The condition’s prevalence varies between 20% and 35%, depending on the group of people studied.
- The rate of corneal arcus increases with age, being virtually universal in individuals over the age of 80.
- Traditionally, men have shown a higher incidence of corneal arcus than women, and they also tend to have larger arcus.
- Corneal arcus mostly doesn’t cause any clinical issues.
- However, in men under 40, its presence can indicate a higher risk of heart disease.
- It was once believed that corneal arcus was a sign of heart disease in all age groups, but current data disputes this notion.
Signs and Symptoms of Arcus Senilis
Corneal arcus is a condition where narrow rings of white or gray cloudy lipid deposits appear around the cornea, which is the clear, front surface of your eye. These rings typically start at the periphery of the cornea and can develop into a complete ring over time. If rings present in individuals younger than 40 years old or if a ring appears on only one side, it may require further investigation.
Testing for Arcus Senilis
Corneal arcus, or rings in the eyes, are usually harmless in elderly individuals. However, if seen in people younger than 50, particularly men, they could be a sign of more secretive diseases related to fat build-up in the arteries, known as atherosclerotic disease. Therefore, doctors may suggest a lipid analysis test, which measures the levels of fats in your blood, for individuals with corneal arcus below the age of 50. That being said, this examination isn’t necessary for individuals over 50.
It’s worth noting that even though there is a strong connection between corneal arcus found in men under 50 and disorders in fat metabolism, sometimes these eye rings can be present without any significant impact on health, even for men under 50. An interesting observation is that, if corneal arcus occurs only in one eye, it could signify a late stage of disease in neck arteries called carotid vascular disease.
Treatment Options for Arcus Senilis
Arcus senilis, on its own, doesn’t require any treatment because it doesn’t cause any symptoms and doesn’t affect health. However, if further tests reveal that it is a symptom of another underlying health issue, such as high cholesterol, then this condition should be managed appropriately. Treatment options for such underlying conditions can include lifestyle modifications and medication.
What else can Arcus Senilis be?
The process of diagnosing corneal arcus, a condition where the outline of the iris (the colored part of your eye) appears gray or white, can be complicated because it can be linked to many different conditions. For example, some studies have found a connection between heavy drinking and having corneal arcus. However, this is likely because consuming alcohol increases the amount of free fatty acids (the building blocks of fat) in your body, not because of the alcohol itself.
People under the age of 50 who have corneal arcus may have a hidden disease known as atherosclerosis, which is when your arteries become narrow due to a buildup of cholesterol and other substances. Corneal arcus usually appears in both eyes at the same time. But, if it only appears in one eye, it can be a sign of a condition called unilateral carotid artery stenosis, which is a narrowing of the main artery in the neck that carries blood to your brain, face, and neck.
One theory suggests that this happens because the blood flow to the eye on the same side as the narrowed artery is reduced. As a result, that eye could be “shielded” from developing corneal arcus. This is because patients with this condition often have another disease that increases their cholesterol levels and therefore, makes them more likely to develop corneal arcus.
In addition, individuals who have genetic disorders that affect the way their body breaks down fats, or metabolic disorders like lecithin-cholesterol acyltransferase deficiency, are at a higher risk of developing corneal arcus. The most common conditions linked to corneal arcus are disorders where lipid (fat) levels in the blood are abnormally high, such as hypercholesterolemia. However, in many cases, corneal arcus is a harmless finding in older individuals.
What to expect with Arcus Senilis
The outlook for corneal arcus, a condition of the eye, is generally positive. These don’t usually cause any problems, and importantly, they don’t impact a person’s sight. There is no evidence that corneal arcus causes sores or promotes new blood vessel growth in the eye. Mainly, people with this condition may be concerned about how it affects their appearance.
Possible Complications When Diagnosed with Arcus Senilis
Typically, there are no problems directly caused by corneal arcus (a greyish, arc-shaped line in front of the peripheral part of the iris). However, the appearance of corneal arcus might be a sign of another existing health issue. These could be a disorder related to fat metabolism in the body or, if it’s appearing only on one eye, it might indicate problems with carotid arteries (the major blood vessels in the neck that supply blood to the brain, neck, and face).
Preventing Arcus Senilis
If during a physical exam doctors notice a condition called cornea arcus, there are several important things that patients should know. First, cornea arcus doesn’t directly impact their health – it won’t affect their eyesight and it’s unlikely to cause any other health issues. Some people might worry about how it looks, but it’s important to remember that it isn’t damaging their health.
However, the presence of cornea arcus could hint at another underlying health problem, so they might need further health checks. It’s also worth knowing that the cornea arcus are likely to remain, even if any underlying health issue is identified and treated. Lastly, although it might change the appearance of their eyes, the emotional impact is just as important, and patients should be reassured and supported in regards to this.
