Corneal Arcus: What the Ring Around Your Cornea Means

Can corneal arcus predict your heart attack risk?

Updated on July 29, 2021

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Some people develop a gray, white, or bluish circle around all or part of the colored part of the eyeball (called the cornea). Sometimes referred to as a "ring around the pupil," the condition is officially known as corneal arcus. It can also be referred to as arcus senilis in older people and arcus juvenilis in younger people.

Corneal arcus may appear as an arc above or beneath the cornea, or it may form an entire ring around the cornea. While it is often considered benign, particularly in the elderly, evidence suggests that if may predictive of heart disease in younger people.

About Arcus Senilis

Arcus senilis is common among elderly people. The whitish arc is caused by the deposit of fat (lipids) around the cornea. The condition is typically associated with higher cholesterol levels. Discoloration caused by arcus senilis does not decrease vision or harm the eye.

Corneal arcus is more prevalent in men than in women and in Blacks than in whites. Its prevalence increases with advancing age. It is associated with hypercholesterolemia, alcohol, hypertension (high blood pressure), smoking, diabetes, age, and coronary heart disease.

With that being said, the appearance of arcus senilis over the age of 50 is not inherently linked to an increased risk of disease. Rather, it tends to mirror the expected rate of hypertension, diabetes, and coronary heart disease in people of that age group.

About Arcus Juvenilis

While considered relatively benign in older adults, most ophthalmologists will recommend that people under 50 with corneal arcus should have their blood tested to check for hypercholesterolemia (elevated cholesterol levels) and other lipid-related abnormalities.

A 2010 study from Boston University found that corneal arcus under 45 was associated with high "bad" LDL cholesterol levels (average 133 mg/dL). Of the 3,890 adults with arcus juvenilis, one in 10 was already on hypertension therapy.

Moreover, by the age of 64, the study predicted that this same group of individuals would not only have excessively high LDL levels (154 mg/dL) but high triglycerides (115 mg/dL), high total cholesterol (232 mg/dL), and a high systolic blood pressure (138 mm Hg). All of these factors are highly predictive of CHD and CVD.

When to See Your Healthcare Provider

Arcus senilis is essentially a harmless condition in older people. So, too, are some changes in eye color. For example, a baby's eye color can change and change again until they are up to 3 years of age.

Other changes in eye color should be checked out by your ophthalmologist or optometrist. For example:

If the whites of your eyes have turned yellow, you may be suffering from jaundice, a condition associated with liver problems.
Red eyes may be also be related to a subconjunctival hemorrhage, a condition symptomatic of diabetes, hypertension, or even leukemia.
Red spots could be a symptom of sickle cell disease or a benign or cancerous tumor.
Conjunctivitis ("pink eye") is a highly contagious infection of the eye that can cause itching and pain.
Whitening or discoloration over your pupil can be a sign of cataracts.

Frequently Asked Questions

What is corneal arcus?

Corneal arcus is a condition common in older adults in which deposits of fats and cholesterol around the outer edge of the cornea cause a bluish, whitish, or light gray ring. Corneal arcus occurs in almost all males over 80 and females over 90.
What else is corneal arcus called?

Corneal arcus is referred to by other names, including arcus senilis, arcus lipoides, arcus adiposus, arcus cornealis, and gerontoxon. If it occurs in people under 50, it is referred to as arcus juvenilis.
What causes corneal arcus?

Corneal arcus is caused by the leakage of lipoproteins—which include cholesterol—from the capillaries surrounding the cornea into the cornea itself. The deposit is made up primarily of “bad” low-density lipoprotein (LDL) cholesterol.
What is corneal arcus a sign of?

Corneal arcus is generally considered benign in older adults if it occurs in both eyes. If it occurs in one eye, it may be the sign of carotid artery stenosis or decreased intraocular pressure, both of which require treatment. In people under 50, corneal arcus is typically a sign of hypercholesterolemia (high cholesterol).
How is corneal arcus diagnosed?

Corneal arcus is diagnosed with a physical examination of the eye by an ophthalmologist using a lighted scope called a slit lamp.
How do you treat corneal arcus?

You don’t. Corneal arcus doesn’t affect a person’s vision or cause anything more than cosmetic concerns. However, in people under 50, corneal arcus suggests the need for lipid screening to determine if treatment is needed to help lower cholesterol and, in turn, the risk of heart disease.