Arcus Senilis (Arcus Corneal)

Four representative slides of corneal arcus[1]

Arcus senilis is an age-related eye disorder characterized by deposition of lipids and cholesterol on the outer border of the cornea. It is often considered as a prognostic factor for cardiovascular diseases and may reflect hypercholesterolemia or hypertriglyceridemia. The diagnosis can be made during physical examination or with the use of a slit lamp. As the condition is benign and produces no symptoms, therapeutic strategies do not exist.

Arcus Senilis arises due to the following process: degenerative.

Presentation

All individuals who develop arcus senilis are asymptomatic and the diagnosis is often made incidentally. Visual disturbances are absent and bilateral development is observed in most cases.

Skin
Xanthoma
  • NAME* (According to the recommendations of the Human Genome Variation Society at www.hgvs.org/mutnomen/ ) : File (Do not fill in this space) : CLINICAL INFORMATIONS ( Without treatment or diet) Total cholesterol (mmol/l) : HDL cholesterol (mmol/l) : Xanthomas[umd.be]
  • Indications for measuring blood cholesterol are: a family history of premature coronary heart disease or hyperlipidaemia, personal history of coronary heart disease , clinical evidence of raised lipids (xanthelasma, corneal arcus under 50, xanthomas at[wikigenes.org]
  • […] arcus under 50, xanthomas at [wikigenes.org] There seems to be a genetic relationship between familial hyper β-lipoproteinemia, atherosclerosis, xanthelasma, tendinous xanthoma and arcus senilis.[symptoma.com]
  • There seems to be a genetic relationship between familial hyper β-lipoproteinemia, atherosclerosis, xanthelasma, tendinous xanthoma and arcus senilis.[link.springer.com]
  • more...
  • Eyes
    Arcus Senilis
    • […] of arcus senilis, greying of hair, and baldness.[malacards.org]
    • Image credit: Afrodriguezg, 2014 Arcus senilis is also known as arcus senilis corneae.[medicalnewstoday.com]
    • Origin: From Latin, arcus senilis Freebase (0.00 / 0 votes) Rate this definition: Arcus senilis Arcus senilis is a white, gray, or blue opaque ring in the corneal margin, or white ring in front of the periphery of the iris.[definitions.net]
    • arcus-senilis Wiktionary: arcus senilis A faint whitish ring around the iris in elderly people; discoloration of the iris with age. (16 of 17 words) en​.wiktionary​.org​/wiki​/arcus senilis[memidex.com]
    Corneal Opacity
    • [symptoma.com] Corneal Opacity Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity ), or white ring in front of the periphery of the iris.[symptoma.com]
    • Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[en.wikipedia.org]
    • Am 15.10.2014 veröffentlicht Arcus senilis (or arcus senilis corneae) is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[youtube.com]
    • Arcus senilis (or arcus senilis corneae) is a white or gray opaque ring in the corneal margin (peripheral corneal opacity), white ring around the iris.[bookdepository.com]
    • Disease relevance of Arcus Senilis Schnyder corneal crystalline dystrophy ( SCCD ) comprises corneal opacities often associated with precocious arcus senilis and genua valga [1] .[wikigenes.org]
  • more...
  • cardiovascular
    Vascular Disease
    • "Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study" .[en.wikipedia.org]
    • [reviewofoptometry.com] Vascular Disease "Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study" .[symptoma.com]
    • It is suggested that in the negro at least, the development of arcus is genetically determined, rather than a reflection of a generalized lipid disturbance or of generalized vascular disease.[annals.org]
  • more...
  • neurologic
    Confusion
    • Arcus senilis can be confused with the limbus sign , which reflects calcium rather than lipid deposits.[en.wikipedia.org]
    • Arcus senilis can be confused with the limbus sign, which reflects calcium rather than lipid deposits.[youtube.com]
    • Prominent epicanthal folds commonly confuse laymen... ‎[books.google.de]
    • [symptoma.com] more... neurologic Confusion Arcus senilis can be confused with the limbus sign , which reflects calcium rather than lipid deposits.[symptoma.com]
  • more...
  • Entire body system
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  • Workup

    The initial diagnosis can be made during physical examination, when white, yellow or grayish opacities on the outer corneal border (at the corneoscleral junction) can be observed. Depending on the severity of lipid accumulation, opacities can be located only at the poles or a ring-like formation can be noted in later stages. As mentioned previously, bilateral presentation is almost universal, but to confirm the diagnosis, the slit lamp examination is necessary. A clear visualization of the lipid ring and the lucid interval of Vogt, a very subtle clear area between the sclera and the arcus that further confirms the diagnosis. Additional findings during this examination may include increased intraocular pressure (IOP) and lower central corneal thickness [10]. In all patients with arcus senilis, a full lipid panel consisting of LDL, HDL, total cholesterol and triglycerides should be obtained, as well as blood glucose levels, as it has shown to be associated with hyperlipidemia and diabetes mellitus, respectively [4].

    Laboratory

    Microbiology
  • more...
  • Treatment

    At this moment, treatment strategies do not exist for this condition, as it does not cause any symptoms nor does it interfere with vision. The focus of treatment should be directed to hyperlipidemia and hypercholesterolemia (if present) and the use of lipid-lowering drugs such as statins should be advocated, as well as evaluation of dietary habits and potential corrections.

    Prognosis

    Arcus senilis is a benign and self-limiting condition that does not pose a risk for the patient's vision or general health. Certain studies have attempted to asses whether arcus senilis is a prognostic factor for myocardial infarction, coronary heart disease, dyslipidemia and increased intraocular pressure, but conflicting results have been obtained. Nevertheless, many patients in whom arcus senilis was diagnosed had elevated serum levels of LDL and reduced HDL [9], which is why it is necessary to perform these laboratory tests.

    Complications

    Wilson Disease
    • Causes Wilson Disease Wilson's disease - the Kayser-Fleischer ring occurs when copper is deposited around the periphery of the cornea.[symptoma.com]
    • Wilson's disease - the Kayser-Fleischer ring occurs when copper is deposited around the periphery of the cornea.[patient.info]
    Familial Hypercholesterolemia
    • "Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia" .[en.wikipedia.org]
    • Homozygous Familial Hypercholesterolemia Cerebrovascular Disorder Arcus Senilis Cerebrovascular Disorder arcus cornean Temporomandibular Joint Disorder Homozygous Familial Hypercholesterolemia Cerebrovascular Disorder Cerebrovascular Disorder Puerperium[symptoma.com]
    • Hypercholesterolemia Cerebrovascular Disorder Arcus Senilis Cerebrovascular Disorder arcus cornean Temporomandibular Joint Disorder Homozygous Familial [symptoma.com] [icd.codes] Cerebral Amyloid Angiopathy arcus cornean disorders with mcc 071 Nonspecific[symptoma.com]
    • Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia.[reviewofoptometry.com]
    • [patient.info] Familial Hypercholesterolemia "Correlating corneal arcus with atherosclerosis in familial hypercholesterolemia " .[symptoma.com]
    Corneal Opacity
    • [symptoma.com] Corneal Opacity Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity ), or white ring in front of the periphery of the iris.[symptoma.com]
    • Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[en.wikipedia.org]
    • Am 15.10.2014 veröffentlicht Arcus senilis (or arcus senilis corneae) is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[youtube.com]
    • Arcus senilis (or arcus senilis corneae) is a white or gray opaque ring in the corneal margin (peripheral corneal opacity), white ring around the iris.[bookdepository.com]
    • Disease relevance of Arcus Senilis Schnyder corneal crystalline dystrophy ( SCCD ) comprises corneal opacities often associated with precocious arcus senilis and genua valga [1] .[wikigenes.org]
    Corneal Neovascularization
    • CORNEAL NEOVASCULARIZATION (neo'-vas-cu-lar-ize-a-tion) Corneal neovascularization describes new growth of, undesired blood vessels into the normally clear cornea.[coopereyecare.com]
    Vascular Disease
    • "Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study" .[en.wikipedia.org]
    • [reviewofoptometry.com] Vascular Disease "Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study" .[symptoma.com]
    • It is suggested that in the negro at least, the development of arcus is genetically determined, rather than a reflection of a generalized lipid disturbance or of generalized vascular disease.[annals.org]
    Hyperlipidemia
    • Causes [ edit ] It results from cholesterol deposits in or hyalinosis of the corneal stroma, and may be associated with ocular defects or with familial hyperlipidemia .[en.wikipedia.org]
    • It can be a sign of disturbance in lipid metabolism, an indicator of conditions such as hypercholesterolemia, hyperlipoproteinemia or hyperlipidemia. show more[bookdepository.com]
    • Corneal arcus and hyperlipidemia : findings from an older population.[symptoma.com]
    • It results from cholesterol deposits in or hyaline degeneration of the corneal stroma and may be associated with ocular defects or with familial hyperlipidemia . arcus seni lis arcus corneae in the elderly.[medical-dictionary.thefreedictionary.com]
    Hypercholesterolemia
    • It can also appear earlier in life as a result of hypercholesterolemia .[en.wikipedia.org]
    • [link.springer.com] Hypercholesterolemia It can also appear earlier in life as a result of hypercholesterolemia .[symptoma.com]
    • It can also appear earlier in life as a result of hypercholesterolemia.[youtube.com]
    • It can be a sign of disturbance in lipid metabolism, an indicator of conditions such as hypercholesterolemia, hyperlipoproteinemia or hyperlipidemia. show more[bookdepository.com]
    • Homozygous Familial Hypercholesterolemia Cerebrovascular Disorder Arcus Senilis Cerebrovascular Disorder arcus cornean Temporomandibular Joint Disorder Homozygous Familial Hypercholesterolemia Cerebrovascular Disorder Cerebrovascular Disorder Puerperium[symptoma.com]
    Arteriosclerosis
    • […] exposure [emedicine.medscape.com] Chronic Alcoholism Osteopenia and Osteoporosis arcus cornean Diabetes Mellitus Osteopenia and Osteoporosis arcus cornean Chronic Obstructive Pulmonary Disease Osteopenia and Osteoporosis arcus cornean Lower Extremity Arteriosclerosis[symptoma.com]
    • [symptoma.com] Arcus lipoides corneae and arteriosclerosis .[symptoma.com]
    • OGSTON D. 1965 24 Arcus senilis and coronary artery disease. ( 5842529 ) MCANDREW G.M....OGSTON D. 1965 25 THE INCIDENCE OF ARCUS SENILIS IN ISCHAEMIC HEART-DISEASE ITS RELATION TO SERUM-LIPID LEVELS. ( 14247887 ) RIFKIND B.M. 1965 26 Arcus senilis and arteriosclerosis[malacards.org]
    • […] diagnosis, and treatment [books.google.com] […] of cerebrovascular disorders in children with many evidence-based management guidelines The third edition has been updated to include recommendations from the AHA consensus [books.google.com] Cerebral Arteriosclerosis[symptoma.com]
    • Arcus lipoides corneae and arteriosclerosis.[link.springer.com]
    Congenital Abnormality
    • Clinical Aspects 605 Abha Gulati and Reza Dana 629 Blepharitis and Meibomian Gland 647 Recurrent Erosion Syndrome 657 Superior Limbic Keratoconjunctivitis 663 Thanh HoangXuan 669 Rosacea 677 679 Parveen K Nagra and Peter R Laibson 688 Gary N Foulks 699 Congenital[books.google.com]

    Etiology

    Deposition of lipids and cholesterol esters and connective tissue degeneration as a result of age-related changes is the cause of arcus senilis. Current studies hypothesize that the origin of these changes stems from atherosclerosis of corneal vessels and subsequent accumulation of triglycerides and cholesterol in the extracellular matrix [7]. Although hyperlipidemia and hypercholesterolemia have been considered as contributing factors to development of arcus senilis, these findings require additional confirmation, but arcus senilis has been often referred together with xanthelasmas (sharply demarcated, yellowish plaques that develop on either lower or upper eyelids), which arise as a result of high serum lipid levels [7].

    Causes

    Wilson Disease
    • Causes Wilson Disease Wilson's disease - the Kayser-Fleischer ring occurs when copper is deposited around the periphery of the cornea.[symptoma.com]
    • Wilson's disease - the Kayser-Fleischer ring occurs when copper is deposited around the periphery of the cornea.[patient.info]

    Epidemiology

    Studies have shown that approximately 20-35% of the population develop this clinical entity in advanced age [8], but the incidence is reported to be as high as 80% and a strong gender predilection toward males has been commonly observed [9]. In general, prevalence rates rise as age increases, with isolated reports showing a 26%-41% prevalence in the age group 30-49 years and 59%-86% in the age group 50-69 years for female and male gender, respectively [9]. Other studies in randomized samples report an overall prevalence rate of around 50% [10].

    Sex distribution
    Age distribution

    Pathophysiology

    The main and practically only pathophysiological mechanism in arcus senilis is accumulation of lipids in the corneal stroma. Normally, the extracellular matrix is composed of fibroblasts and a network of blood vessels composed of smooth muscle cells, but in advanced age, degeneration of connective tissue and atherosclerosis are considered as underlying mechanisms for deposition of cholesterol esters, triglycerides and phospholipids. As a result, a distinct yellowish-to-white appearance is characteristic for arcus senilis [4]. Accumulation initially starts on the inferior poles and then progressively spread to the superior pole, eventually forming a ring-like structure that is located on the outer corneal rim [2].

    Prevention

    Since a more or less clear association between arcus senilis and disturbed levels of LDL, HDL and triglycerides, preventive strategies may include dietary corrections and lifestyle changes that will result in improvement of lipid profile. As this entity is an age-related process, however, little can be done in terms of preventing its appearance.

    Summary

    Arcus senilis is one of the many changes in the eye that occur as a result of aging and comprises accumulation of lipids in the corneal stroma, usually forming a ring-like opacity on the very periphery of the cornea [1], at the sclerocorneal junction. Macroscopically, arcus senilis appears as a yellow-grayish-white arc that has a sharply demarcated outer and indistinct inner border [2]. It usually starts in the superior or inferior corneal pole and eventually develops and encompasses the entire circumference, whereas the presence of the lucid interval of Vogt (a clear area between the arcus senilis and the sclera) is considered as one of the hallmarks of this condition [2]. As a result of progressive degenerative changes in the eye due to aging, accumulation of lipids, mainly cholesterol esters, but also triglycerides in the extracellular matrix of the corneal stroma occurs. [3] Studies have further confirmed the age-related etiology by observing that tissue necrosis and atrophy do not occur and that pileup of fats is the only pathological event [1]. Arcus senilis has often been mentioned as a prognostic and predictive marker of cardiovascular disease, hypertriglyceridemia and hypercholesterolemia, while its clear association with alcoholism, diabetes mellitus, smoking, obesity and hypertension needs further clarification [4]. Advanced age is certainly the single most important risk factor and in terms of gender predisposition, a male predominance has been observed in various reports [5]. Clinical presentation is asymptomatic, since arcus senilis does not produce any symptoms or signs, nor does it cause any visual disturbances. The diagnosis can be made during regular physical examination, as this formation can be seen with the naked eye during close inspection. A more direct view can be achieved by the use of a slit lamp, which can detect the corneal arcus with great precision [4]. If the diagnosis is confirmed, it is recommended to obtain serum values of both high-density and low-density lipoproteins (HDL and LDL, respectively), total cholesterol and triglycerides, but it is not uncommon for patients to have normal values of circulating lipids [6]. Since arcus senilis does not cause any symptoms and poses no risk for the patient, treatment principles currently do not exist.

    Patient Information

    Arcus senilis is a benign ocular condition that is characterized by deposition of fats on the outer part of the cornea, which is responsible for light refraction. As the name implies, this disorder arises due to aging and degeneration of connective tissue situated in the cornea, which results in accumulation of cholesterol and triglycerides. As a result, a yellowish, grayish or white opacity on the border of the cornea and sclera (the white part of the eye) appears. Initially, these opacities develop on either upper or lower pole, but as accumulation and age progress, a ring-like formation can be observed, especially in older individuals. It is hypothesized that virtually all individuals will eventually develop arcus senilis at some point and isolated studies indicate that up to 80% of males and 50% of females aged between 50-69 years suffer from this age-related disorder. Gender predilection toward males is commonly observed. In many reports, this condition has been reported to be in association with increased levels of circulating cholesterol, indicating that atherosclerosis, hyperlipidemia and other illnesses that trigger such events may serve as predisposing factors. Diabetes mellitus, smoking and alcohol consumption have also been brought into connection with arcus senilis, but further studies are necessary to identify their exact link. The course of the disease is completely asymptomatic, as arcus senilis does not induce any symptoms, nor does it impair vision, which is why it is often discovered incidentally during regular check-ups. The initial diagnosis can be made just by close inspection of both eyes (in virtually all patients, both eyes are affected), but to confirm arcus senilis, a slit lamp examination that is usually performed by an ophtalmologist is performed. It is highly recommended to draw blood for evaluation of cholesterol and triglyceride levels in these individuals, due to the fact that is has been commonly associated with cardiovascular diseases. Treatment principles currently do not exist, as this condition does not cause any harm to the patient and it is interpreted as a manifestation of aging. Nevertheless, dietary changes and correction of possibly elevated lipid levels in blood should be performed to preserve the cardiovascular system.

    Other symptoms

    Aging
    Iris
    • This posterior layer gives a spoke-like appearance to the pupillary iris, and it can be seen in iris crypts in the periphery of the iris as well as in the varied texture of the iris near the pupil.[wordpress.artificialeyeclinic.com]
    • […] in elderly people; discoloration of the iris with age .[en.wiktionary.org]
    • […] in elderly people; discoloration of the iris with age. (16 of 17 words) en​.wiktionary​.org​/wiki​/arcus senilis[memidex.com]
    • […] in elderly people; discoloration of the iris with age.[definitions.net]
    No Abnormalities
    • [clevelandclinicmeded.com] Lymphoma Osteopenia and Osteoporosis Lymphangiogram Abnormal arcus cornean Multiple Myeloma Osteopenia and Osteoporosis Lymphangiogram Abnormal arcus cornean Malignant Melanoma Lymphangiogram Abnormal osteopenia and osteoporosis[symptoma.com]
    • If corneal arcus is found in a patient younger than 40 (often arcus juvenilis), blood tests are definitely recommended to rule out lipid and cholesterol abnormalities.[mastereyeassociates.com]
    • E10.3- , E11.3- , E13.3- ) endocrine, nutritional and metabolic diseases ( E00 - E88 ) injury (trauma) of eye and orbit ( S05.- ) injury, poisoning and certain other consequences of external causes ( S00-T88 ) neoplasms ( C00-D49 ) symptoms, signs and abnormal[icd10data.com]
    • What would need to be looked into and treated is the dyslipidaemia if this is found to be abnormal in order to avoid cardiovascular risk.[ipohecho.com.my]
    • [sciencephoto.com] No Abnormalities [clevelandclinicmeded.com] Lymphoma Osteopenia and Osteoporosis Lymphangiogram Abnormal arcus cornean Multiple Myeloma Osteopenia and Osteoporosis Lymphangiogram Abnormal arcus cornean Malignant Melanoma Lymphangiogram[symptoma.com]
    Arcus Juvenilis
    Birth
    • Although the risks are rare, very low levels of LDL cholesterol may be associated with an increased risk of: Cancer Hemorrhagic stroke Depression Anxiety Preterm birth and low birth weight if your cholesterol is low while you're pregnant The potential[answers.webmd.com]
    • It is present at birth but then fades; however, it is quite commonly present in the elderly.[en.wikipedia.org]
    • It is present at birth, but then fades; however, it is quite commonly present in the elderly.[youtube.com]
    • It is present at birth but then fades; however it is quite commonly present in the elderly.[bookdepository.com]
    • It's present at birth, but then fades; however, it's quite commonly present in the elderly.[memidex.com]
    Old Age
    • Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[en.wikipedia.org]
    • […] noun Medicine A narrow opaque band encircling the cornea, common in old age.[en.oxforddictionaries.com]
    • It occurs mainly in people of old age, rarely young, sometimes it can be congenital.[medicalency.com]
    • […] often seen in elderly people (14 of 263 words, pronunciation) www​.collinsdictionary​.com​/dictionary​/english​/arcus-senilis Oxford Dictionary: arcus senilis Syllabification: (ar·cus se·ni·lis) a narrow opaque band encircling the cornea, common in old[memidex.com]
    Familial Hyperlipidemia
    • Causes [ edit ] It results from cholesterol deposits in or hyalinosis of the corneal stroma, and may be associated with ocular defects or with familial hyperlipidemia .[en.wikipedia.org]
    • It results from cholesterol deposits in or hyaline degeneration of the corneal stroma and may be associated with ocular defects or with familial hyperlipidemia . arcus seni lis arcus corneae in the elderly.[medical-dictionary.thefreedictionary.com]
    Congenital
    • Specialists from the prestigious Wills Eye Hospital share their expertise in diagnosing and treating congenital and acquired disorders affecting the internal and external structures of the eye.[books.google.com]
    • It occurs mainly in people of old age, rarely young, sometimes it can be congenital.[medicalency.com]
    • Arcus occurs occasionally as a congenital anomaly (arcus juvenilis), usually involving only a sector of the peripheral cornea and not associated with abnormalities of serum lipid.[aao.org]
    • [wikigenes.org] Congenital Specialists from the prestigious Wills Eye Hospital share their expertise in diagnosing and treating congenital and acquired disorders affecting the internal and external structures of the eye.[symptoma.com]
    No Corneal Opacities
    • [symptoma.com] Corneal Opacity Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity ), or white ring in front of the periphery of the iris.[symptoma.com]
    • Arcus senilis is an old age syndrome where there is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[en.wikipedia.org]
    • Am 15.10.2014 veröffentlicht Arcus senilis (or arcus senilis corneae) is a white, grey, or blue opaque ring in the corneal margin (peripheral corneal opacity), or white ring in front of the periphery of the iris.[youtube.com]
    • Arcus senilis (or arcus senilis corneae) is a white or gray opaque ring in the corneal margin (peripheral corneal opacity), white ring around the iris.[bookdepository.com]
    • Disease relevance of Arcus Senilis Schnyder corneal crystalline dystrophy ( SCCD ) comprises corneal opacities often associated with precocious arcus senilis and genua valga [1] .[wikigenes.org]
    Hyperlipoproteinemia
    • […] study of 12,745 Danes followed up for a mean of 22 years found that it had no clinical value as a predictor of cardiovascular disease. [2] It can be a sign of disturbance in lipid metabolism , an indicator of conditions such as hypercholesterolemia , hyperlipoproteinemia[en.wikipedia.org]
    • Contributor: Jesse Vislisel, MD Photographer: Toni Venckus, CRA Corneal arcus, also known as arcus senilis or gerontoxon, is a common degenerative change of the peripheral cornea in older adults, but may be a sign of hyperlipoproteinemia in individuals[webeye.ophth.uiowa.edu]
    • It can be a sign of disturbance in lipid metabolism, an indicator of conditions such as hypercholesterolemia, hyperlipoproteinemia or hyperlipidemia. show more[bookdepository.com]
    • , an indicator of conditions such as hypercholesterolemia , hyperlipoproteinemia or hyperlipidemia .[symptoma.com]
    • However, arcus is sometimes indicative of a hyperlipoproteinemia (involving low-density lipoproteins) with elevated serum cholesterol, especially in patients under 40 years of age (see Chapter 11).[aao.org]
    Metabolic Disease
    • Diabetic patients are more prone to cataract; other causes of cataract are metabolic disease, direct injury, and prolonged exposure to infrared rays of light.[sciencephoto.com]
    • […] complications of pregnancy, childbirth and the puerperium ( O00-O9A ) congenital malformations, deformations, and chromosomal abnormalities ( Q00-Q99 ) diabetes mellitus related eye conditions ( E09.3- , E10.3- , E11.3- , E13.3- ) endocrine, nutritional and metabolic[icd10data.com]
    • [hyper-db.de] Metabolic Disease Diabetic patients are more prone to cataract; other causes of cataract are metabolic disease , direct injury, and prolonged exposure to infrared rays of light.[symptoma.com]
    Lipid Accumulation
    • Accumulation Depending on the severity of lipid accumulation , opacities can be located only at the poles or a ring-like formation can be noted in later stages.[symptoma.com]
    • Lipid accumulation is found in the peripheral corneal stroma, Bowman's membrane and Descemet's membrane as well as in the perilimbal region of the sclera.[link.springer.com]
    Corneal Abnormality
    • [link.springer.com] Corneal Abnormality Congenital problems [ 11 , 12 ] Babies with suspected corneal abnormalities should be referred urgently, even if they appear otherwise well.[symptoma.com]
    • Congenital problems [ 11 , 12 ] Babies with suspected corneal abnormalities should be referred urgently, even if they appear otherwise well.[patient.info]
    Aged Appearance
    • For most people, arcus senilis is no cause for concern, and it will appear eventually in almost everyone who reaches old age.[medicalnewstoday.com]

    Self-assessment

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    References

    1. Raj KM, Reddy PAS, Kumar VC. Significance of corneal arcus. J Pharm Bioallied Sci. 2015;7(1):S14-S15.
    2. Salvi SM, Akhtar S, Currie Z. Ageing changes in the eye. Postgrad Med J. 2006;82(971):581-587.
    3. Nair PA, Patel CR, Ganjiwale JD, Diwan NG, Jivani NB. Xanthelasma Palpebrarum with Arcus Cornea: A Clinical and Biochemical Study. Indian J Dermatol. 2016;61(3):295-300.
    4. 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.
    5. Moss SE, Klein R, Klein BE. Arcus senilis and mortality in a population with diabetes. Am J Ophthalmol. 2000;129(5):676-678.
    6. Chua BE, Mitchell P, Wang JJ, Rochtchina E. Corneal arcus and hyperlipidemia: findings from an older population. Am J Ophthalmol. 2004;137(2):363-365.
    7. Christoffersen M, Frikke-Schmidt R, Schnohr P, Jensen GB, Nordestgaard BG, Tybjærg-Hansen A. Xanthelasmata, arcus corneae, and ischaemic vascular disease and death in general population: prospective cohort study. The BMJ. 2011;343:d5497.
    8. Rumelt S, Rumelt-Blitstein I. Double arcus cornealis. Eye. 2004;18:1020–1021.
    9. Lertchavanakul A, Laksanaphuk P, Tomtitchong T. Corneal arcus associated with dyslipidemia. J Med Assoc Thai. 2002;85(1):S231-235.
    10. Wu R, Wong TY, Saw SM, Cajucom-Uy H, Rosman M, Aung T. Effect of corneal arcus on central corneal thickness, intraocular pressure, and primary open-angle glaucoma: the Singapore Malay Eye Study. Arch Ophthalmol. 2010;128(11):1455-1461.



    Media References

    1. Four representative slides of corneal arcus, CC BY 2.0

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