What Is Arcus Senilis? What Are Causes, Signs And Diagnosis

Aarcus senilis (also called the corneal arch or senile arch) is a semicircle of gray, white, or yellow deposits on the outer edge of the cornea . Basically, these deposits are composed of cholesterol and fat. It often occurs without predisposing systemic diseases and is characterized by peripheral opacity.

What is an arcus senilis?

The corneal arch is common among the elderly, which is why it got its alternative name – the arcus senilis. Corneal arches in young adults may be associated with high cholesterol levels .

Despite the fact that the senile arch does not pose an immediate threat to the patient’s vision, a visit to the doctor is required, since it may indicate the presence of serious health problems .

Causes of arcus senilis 

The arcus senilis is the accumulation of fat in the outer part of the cornea. Cholesterol and triglycerides are two types of fats in the blood. Some of the fat comes from the foods we eat. The rest is made by our liver.

The appearance of a corneal arch does not mean that you have liver problems or high cholesterol levels. One of the causes of an age-related arch is the dilation of the blood vessels in the eyes, which allows cholesterol and other fats to enter the cornea unhindered in large enough quantities to be visible to the naked eye.

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It is known that the arcus senilis is diagnosed in 50% of people aged 50 to 60 years, and in 98% at the age of 80 years. In addition, it is statistically proven that the age-related arch is more common in men and African Americans.

Another cause of age-related arches is an inherited condition that causes high levels of cholesterol and triglycerides in the blood all the time. In this case, the corneal arch appears after 40 years. In extremely rare cases, the corneal arch can be diagnosed even in infants.

It is important to know that senile arch can be a symptom of Schneider’s crystalline corneal degeneration, a rare genetic condition that causes cholesterol to be deposited in the cornea.

In some cases, a connection between the senile arc and dyslipoproteinemia (familial and other genesis) is revealed. Hyperlipoproteinemia, especially type II, is often associated with bilateral formation of the senile arch, less often such a relationship can be traced in hyperlipoproteinemia of types III, IV and V. Unilateral arcus senilis is a rare occurrence that can be combined with damage to the carotid artery or hypotension of the eye. Thearcus senilis is also often detected in patients with crystalline corneal dystrophy.

Sign and Symptoms of an Age-related Arcus Senilis

  • the appearance of a white, gray or yellow circle on the upper and / or lower part of the cornea;
  • the appearance of an arc does not affect vision in any way;
  • Over time, a semicircle can form a full circle around the iris.
  • The deposition of lipids in the stroma begins in the upper and lower perilimbal zones, spreads around the circumference of the cornea and leads to the formation of a strip about 1mm wide.
  • The arch has a wider vertical dimension than the horizontal meridian of the cornea.
  • The inner border of the arc facing the center of the cornea is blurred, and the outer one is clearly identified and separated from the limbus by a transparent zone.
  • This transparent area of ​​the perilimbal zone sometimes becomes thinner, but the process is always moderately pronounced (senile sulcus).

Diagnosis and treatment of the arcus senilis

A arcus senilis can be diagnosed during a physical examination using a slit lamp – a special ocular microscope. To confirm the diagnosis, the doctor may use drops that dilate the pupil. They will allow him to examine the vessels in the back of the eye. If the vessels are dilated, this will be another proof of the senile arch.

Other tests and tests prescribed by a doctor may be aimed at finding the causes that caused the appearance of the corneal arch:

  • blood test and lipid profile to check the level of cholesterol in the blood;
  • angiogram of blood vessels to exclude atherosclerosis – blockage of blood vessels with fatty deposits;
  • liver function tests to check the condition of the liver.

The senile arch does not need treatment. If, during the diagnosis process, a patient has liver problems or high cholesterol levels, the doctor recommends lifestyle changes to reduce the risk of atherosclerosis.

It is important to understand that the senile arc will not go away on its own. It can be masked with a tattoo of the iris of the eye, but doctors do not recommend resorting to such methods.

The prevalence of the arcus senilis increases with age. Men are more likely to suffer from the disease. The incidence among women rises sharply in the postmenopausal period. After 80 years, the disease develops in almost 100% of the population. The arcus senilis does not affect vision and does not require treatment. However, this disease (especially in patients under 40 years of age) is an indicator of an increased risk of coronary artery disease. These patients should be monitored regularly for hyperlipoproteinemia.

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