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What Is Arcus Senilis?

Medically Reviewed by Dan Brennan, MD on April 22, 2021

Arcus senilis is when the cornea of your eye has a white or gray ring or arc around it. Your cornea is the transparent outer covering of your eye. 

It’s also known as corneal arcus. It’s common in older people, usually due to aging. But some younger people under the age of 40 may experience arcus senilis, which can be associated with a higher risk for heart disease.

Symptoms of Arcus Senilis

If you have arcus senilis, you will have white or gray rings or half-circle around your cornea. Your cornea allows the color of your iris to show through it. The arcus senilis can make it look as if your iris is of two different colors. 

Arcus senilis may show as a short arc along the top half and bottom half of your cornea. This may eventually fill in to form a complete ring around your cornea.

The arcs are usually bilateral, meaning they’re in both your eyes. But if it’s present only in one eye, this may signal carotid vascular disease.

These rings shouldn’t cause any vision problems. If you’re above the age of 40, you’re also unlikely to have other symptoms. 

Causes of Arcus Senilis

Your eyes are one of the most complex regions of your body. Sometimes your eyes may be the first part of your body to exhibit signs of diseases that affect other parts of your body or your whole body.

The rings around your cornea are caused by deposits that are made up of fats. Cholesterol, triglycerides, and phospholipids are among the different types of fats circulating in your blood. 

These fats (lipids) come from the food that you eat and from your liver. Your liver makes all the cholesterol your body needs. It’s needed to make hormones and vitamins and build cells. But too much cholesterol means a higher risk of cardiovascular diseases.

Researchers in Singapore tested 3,637 adults aged between 40 to 80 years to see if they had arcs around their corneas. Six years later, they found that 5.7% of participants had developed cardiovascular disease. Those with corneal arcus were more likely to have developed heart disease than those without.

Who’s More Likely to Get Arcus Senilis?

Arcus senilis is common in older people. It affects about 20 to 35% of people. Some research has shown that it may affect nearly 100% of those over the age of 80. Experts have also found that it affects men more than women. Men also tend to have larger rings around their corneas.

People of African and Southeast Asian descent tend to be more likely to have arcus senilis than those who are white.

If you have a family history of high cholesterol, you may have arcus senilis before the age of 40. This is known as arcus juvenilis. Children or young adults with rings around their corneas should see a healthcare professional for an eye exam.

Diagnosis of Arcus Senilis

Your doctor should be able to diagnose arcus senilis with a physical exam. They may use a slit lamp to examine your eyes. Your doctor may refer you to an optometrist or ophthalmologist if further testing is needed.‌

If you’re under the age of 40, your doctor may recommend that you get tests to check your cholesterol and lipid levels

Treatment of Arcus Senilis

There’s no treatment or cure for arcus senilis. But if you’re experiencing arcus juvenilis, you may be at higher risk for coronary heart disease and high cholesterol. 

To reduce your cholesterol, there are some lifestyle changes that you can make:

  • Eat healthier. Eat fewer saturated fats, such as those in red meat and full-fat dairy products. Eat more foods with soluble fiber like oatmeal, apples, and Brussels sprouts. Eat fewer trans fats, such as those in margarine and store-bought pastries and cakes. 
  • Exercise more. With your doctor’s approval, add in more daily physical activity. This can help you increase your high-density lipoprotein (HDL) or “good” cholesterol.
  • Drink less alcohol. Drinking too much alcohol can lead to health problems such as heart failure and strokes. 
  • Stop smoking. If you quit smoking, your HDL cholesterol level will improve.‌

Changing diet and physical activity levels may not be enough for some people with high cholesterol. There are various medications that can help lower your blood cholesterol levels. Talk to your doctor to develop the right treatment plan for you.

Some cholesterol-lowering medications include:

  • Statins. Statins work in your liver to prevent cholesterol from forming. They're most effective at lowering LDL cholesterol. 
  • Ezetimibe (cholesterol absorption inhibitors). This works by stopping your intestine from absorbing cholesterol. 
  • Bile acid sequestrants (bile acid-binding agents). This causes your intestines to get rid of more cholesterol. 
  • PCSK9 inhibitors. This medication lowers your LDL levels. 

Some drugs work on lowering your triglycerides:

  • Fibrates. This medication is good for lowering triglyceride levels and may also help with lowering LDL levels. 
  • Niacin (nicotinic acid). This reduces the amount of triglycerides your liver produces. 
  • Omega-3 fatty acid ethyl esters. These are made from fish oils and are usually recommended along with changes to your diet. 
  • Omega-3 fish oils or omega-3 fatty acids. You need a lot of omega-3 fatty acids to significantly lower triglycerides, so supplementing with capsules may be needed. But large doses can cause serious side effects like increased bleeding and stroke. Use these supplements only under your doctor’s recommendation. 

Show Sources

SOURCES: 

AMERICAN ACADEMY OF OPHTHALMOLOGY: “What Is Arcus Senilis?.”

American Heart Foundation: “Cholesterol 101: An introduction,” “Cholesterol Medications."

American Journal of Ophthalmology: “Is Corneal Arcus Independently Associated With Incident Cardiovascular Disease in Asians?.”

Mayo Clinic: “Top 5 lifestyle changes to improve your cholesterol.”

Pakistan Journal of Ophthalmology: “Double Arcus Senilis.”

StatPearls: “Arcus Senilis.”

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