Causes of a Ring Around the Cornea

Can corneal arcus predict your heart attack risk?

Perhaps you've noticed how some people have a gray, white, or bluish circle around all or part of the colored part of their eye (the iris).

Sometimes referred to as "ring around the pupil," this condition is known as corneal arcus. More specifically, it is called arcus senilis in people in their 60s and up and arcus juvenilis in younger people.

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

Arcus senilis

Afrodriguezg / Wikimedia Commons

This article explains the two types of corneal arcus and when it's time to consult a healthcare provider if you think you might have the condition.

Arcus Senilis

Arcus senilis is common among people who are in their 60s and up. 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 affect the vision or harm the eye.

Corneal arcus is more prevalent in men than in women and in Blacks than in Whites. It becomes more common as all people age.

It is associated with hypercholesterolemia (elevated cholesterol), alcohol use, hypertension (high blood pressure), smoking, diabetes, age, and coronary artery disease.

Arcus Juvenilis

A 2010 study from Boston University found that corneal arcus in those under age 45 was associated with high levels of "bad" low-density lipoprotein (LDL) cholesterol. In the study, this was an average of 133 milligrams per deciliter (mg/dL).

By the age of 64, the study predicted that this same group would not only have excessively high LDL levels (154 mg/dL) but also high triglycerides (115 mg/dL), high total cholesterol (232 mg/dL), and high systolic blood pressure (138 mm Hg). All of these elevated levels are risk factors for heart disease.

Many ophthalmologists tell people under age 50 with corneal arcus to get their blood tested to check for high cholesterol and other lipid-related abnormalities.

When to See Your Healthcare Provider

Arcus senilis is essentially a harmless condition in older people. So, too, are some changes in eye color. This tendency goes way back. For example, a baby's eye color can change several times before they reach 3 years old.

Other changes in eye color should be checked by an optometrist or ophthalmologist. 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 related to a subconjunctival hemorrhage. This is when a blood vessel breaks in the eye. It could be a symptom of diabetes, hypertension, or 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.

Summary

A condition fittingly named "ring around the pupil" has two different names. It's known as arcus senilis in people in their 60s and up and arcus juvenilis in younger people. The condition doesn't hurt, but it could be a sign of future heart trouble in young people.

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 above age 80 and females above age 90.

  • What causes corneal arcus?

    Corneal arcus is caused by the leaking of lipoproteins—which include cholesterol—from the capillaries surrounding the cornea into the cornea itself. The deposit is made up primarily of “bad” (LDL) 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. 

6 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Ang M, Wong W, Park J, et al. Corneal arcus is a sign of cardiovascular disease, even in low-risk persons. Am J Ophthalmol. 2011;152(5):864-71.e1. doi:10.1016/j.ajo.2011.04.014

  2. Moosavi M, Sareshtedar A, Zarei-Ghanavati S, Zarei-Ghanavati M, Ramezanfar N. Risk factors for senile corneal arcus in patients with acute myocardial infarction. J Ophthalmic Vis Res. 2010;5(4):228–231.

  3. Fernández A, Sorokin A, Thompson PD. Corneal arcus as coronary artery disease risk factor. Atherosclerosis. 2007;193(2):235-40. doi:10.1016/j.atherosclerosis.2006.08.060

  4. American Academy of Ophthalmology. Why are my eyes changing color?

  5. Yanoff M, Duker JS. Ophthalmology expert consultation: online and print. Amsterdam: Elsevier Health Sciences

  6. Munjal A, Kaufman EJ. Arcus senilis. In: StatPearls [Internet].

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.