An Overview of Arcus Senilis

Arcus senilis, also sometimes known as arcus senilis corneae, is a white or gray opaque ring or arc that develops around the cornea of the eye. The cornea is the clear, dome-like structure in the front part of the eye that is made of six different layers and normally transparent. The cornea delivers a large part of the refracting power for the eye so that light rays will properly focus on to the retina. The arc or ring that occurs with arcus senilis comes from lipids (fats) or cholesterol deposited in the cornea.

Symptoms

If you develop arcus senilis, you may notice a white or gray half-circle on your eye. The arc can appear both in the upper and lower areas of your cornea. The half-circle will have a sharp outer border and a fuzzy inner border. The lines may eventually fill in to form a complete circle around your iris, the colored part of your eye.

With arcus senilis, you most likely won’t develop any other symptoms, and your vision shouldn’t be affected.

Causes

Arcus senilis will most likely develop in all of our eyes, provided we live long enough. The condition is seen often in the elderly but is sometimes present at birth. When arcus senilis develops in early or middle life, it is referred to as arcus juvenilis.

For most people, arcus is benign and will not affect vision. However, when arcus develops in people younger than about 40 years of age, there is cause for concern. Because arcus consists of lipid deposits, if you have arcus and you are younger than 40, it could represent high lipid blood levels and therefore possible high cholesterol.

The connection between arcus and high cholesterol or atherosclerosis has been very controversial. As far back as 1852, German pathologist Rudolf Virchow discussed an association between corneal arcus and atherosclerosis. However, nearly 40 years later, physician William Osler suggested that arcus was not diagnostic for “fatty degeneration” of the heart.

Diagnosis

When healthcare providers perform an eye examination, many factors are taken into consideration before making an assessment. For example, when a healthcare provider sees arcus in a younger person, they will pay particular attention to their findings in the retina. During the examination, special eye drops will be instilled into the eye to dilate the pupil. When the eye is dilated, the retinal blood vessels are inspected for signs of disease. The blood vessel appearance and thickness can give clues to possible elevated lipid levels and atherosclerosis.

If there appears to be atherosclerosis of the retinal blood vessels, and the patient also happens to have arcus, then it is more likely that they will recommend a visit to your healthcare provider, internist or cardiologist.

Treatment

The good news is, you don’t need to treat arcus senilis. However, your healthcare provider might recommend that you have your cholesterol levels checked, especially if you are under the age of 40, as you may be at higher risk for high cholesterol and coronary artery disease. High cholesterol can be treated in several ways. Your healthcare provider may recommend lifestyle changes, such as exercising more and eating foods low in saturated fat, trans fat, and cholesterol.

As for the visible ring or arc you see on your eye, there really is no good way to make it go away. Some have advocated eye tattooing to help cover it up. However, for the most part, this is not recommended in the medical community. 

A Word From Verywell

Most healthcare provider practice with a general rule in mind when it comes to arcus. In patients over 40 years of age, arcus is most often a benign finding. However, if you are younger than 40, see your practitioner and have your cholesterol blood levels checked. Just because you are younger than 40 and have arcus does not mean you absolutely have elevated lipid levels, but at a very minimum, it is recommended that you have them checked.