What are the other Names for this Condition? (Also known as/Synonyms)

• Arcus Adiposus
• Arcus Lipoides
• Corneal Arcus

What is Arcus Senilis? (Definition/Background Information)

• Arcus Senilis (AS) is a corneal abnormality in older adults caused by the deposition of lipids (fat-like substances), such as cholesterol and phospholipids, at the periphery of the cornea (corneal limbus region) that manifests as an opaque white/gray/blue ring. The condition is generally bilateral (involving both eyes) and a very common reason for peripheral corneal opacity
• Even though Arcus Senilis is typically associated with lipid disorders, including hyperlipidemia and hypercholesterolemia, the condition is usually benign. It is also not uncommon in adults over the age of 60 years, and does not lead to vision impairment
• However, when it is sometimes observed in individuals below the age range of 50-60 years, termed Arcus Juvenilis, the condition may indicate abnormal body cholesterol levels, potentially presenting an elevated risk for cardiovascular diseases

Who gets Arcus Senilis? (Age and Sex Distribution)

• Arcus Senilis is reportedly a common condition in older adults
• A majority of cases (over 70%) are observed in adults above 60 years of age, while a lesser proportion of the cases occur in young and middle-aged adults below 50 years of age
• Both males and females may be affected, although most cases are observed in adult males
• Worldwide, individuals of all races and ethnicity are prone to developing the condition. However, a higher incidence is noted among African Americans

What are the Risk Factors for Arcus Senilis? (Predisposing Factors)

The risk factors for Arcus Senilis may include:

• Advancing age
• Elevated fasting serum triglyceride
• High blood pressure (hypertension)
• Individuals of Afro-American descent
• Male gender
• Smoking

Commonly associated conditions include:

• Dyslipidemia (particularly in adults 50 years and under)
• Familial hypercholesterolemia
• Xanthelasma

When only a single eye is involved, termed unilateral Arcus Senilis, associations with the following conditions may be noted:

• Asymmetric cerebral vascular supply
• Carotid artery stenosis
• Ocular hypotony

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Arcus Senilis? (Etiology)

The exact cause of development of Arcus Senilis is not well-established. It manifests as an opaque corneal ring and is normally asymptomatic.

• In elderly adults, it is thought to be a normal part of aging, resulting in lipid deposition in the boundaries of the cornea. Generally, this is a benign process that is not known to affect vision or eye health (an absence of atrophy and necrosis is noted)
• Associations have been observed with hyperlipidemia in adults over 60 years old, and with dyslipidemia in adults below 60. It is reported that Arcus Senilis may indicate abnormalities involving lipid metabolism in the body

What are the Signs and Symptoms of Arcus Senilis?

In general, Arcus Senilis does not present any significant signs and symptoms.

• In some individuals, a bluish-grayish ring may be visibly observed on the outer corneal region
• Since only the peripheral corneal region is involved (clouded), no significant vision impairment is noted
• In a majority of cases, both the eyes are involved (bilateral); in some cases, only a single eye is affected (unilateral)

Other systemic signs and symptoms may be noted depending on the associated conditions (if any).

How is Arcus Senilis Diagnosed?

Arcus Senilis may be diagnosed by the following observations and tests:

• Physical examination and medical history evaluation
• Assessment of signs and symptoms
• General eye exam
• Lipid profile tests
• Fundoscopic (ophthalmoscopic) examination by an eye specialist, who examines the back part of the eye (or the fundus)
• Visual acuity test using a special and standardized test chart (Snellen chart)
• Slit-lamp examination: This helps in diagnosing the condition
• Gonioscopy, a painless eye exam using special devices
• Visual evoked potential (VEP) test

Tests and procedures to diagnose the associated condition, if any present, is important.

A differential diagnosis to eliminate other conditions may be considered, before arriving at a definitive diagnosis. These may include:

• Eye symptoms of osteogenesis imperfecta
• Pseudogerontoxon
• Terrien marginal degeneration

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Arcus Senilis?

No significant complications of Arcus Senilis are typically noted.

• Rarely, the corneal ring may be prominent enough to affect some vision (reduced visual acuity)
• Unilateral involvement may be indicative of carotid artery disease; this may indicate reduced blood flow to the eyes
• Complications may arise from the associated conditions, if any present

How is Arcus Senilis Treated?

Generally, no treatment measures are required for Arcus Senilis since the condition is typically asymptomatic and does not significantly affect eye health.

• A wait and watch approach may be considered by the healthcare provider, if necessary
• Diagnosing and treating the associated condition, if any present, is important

How can Arcus Senilis be Prevented?

Presently, it is difficult to prevent Arcus Senilis. However, in some cases, the following measures may be considered:

• If there is a family history of a medical condition, then genetic counseling will help assess risks, before planning for a child
• Undertake early and adequate treatment of any health issues that may potentially affect the eye
• Smoking cessation
• Manage stress and maintain a healthy life
• Periodic eye checkup is recommended for elderly adults and individuals with lipid conditions

What is the Prognosis of Arcus Senilis? (Outcomes/Resolutions)

• The prognosis in Arcus Senilis is usually favorable since both eye health and vision are not generally affected, and no treatment is necessary
• The severity of the associated conditions, such as hyperlipidemia, hypercholesterolemia, or dyslipidemia, may affect the overall prognosis

Additional and Relevant Useful Information for Arcus Senilis:

Please visit our Eye & Vision Health Center for more physician-approved health information:

https://www.dovemed.com/health-topics/vision-center/