Humans are able to see the beauty of the world through the gift of eyes. People often take eye health for granted unless the person’s vision is affected. Having good eye vision can be difficult as a person grows older. Older people tend to have problems with their eye vision due to the ageing process itself. In this DoctorOnCall’s article, we will be learning about one of the common eye disorders affecting the elderly known as arcus senilis.
Arcus senilis is a word that describes the white, light grey or bluish ring around the edge of the cornea. It is made up of fatty substances such as lipids and mostly cholesterol. Cornea is the transparent layer with a dome-shaped, located at the very front of the eyes that protects the structure inside the eye. Cornea is essential to eyesight as it helps the eye focus by controlling the entry of light into the eyes. The cornea allows the colour of the iris beneath it to show through. This ring from arcus senilis can make the iris seem to have different colours but it is actually the discolouration of the cornea.
Due to the fact that arcus senilis is made up mostly of cholesterol, you may be thinking that it means that those with arcus senilis have high cholesterol. Arcus senilis may be signs of high cholesterol if it is present in young adults (those below the age of 40). Presence of arcus senilis in men under the age of 40 has been associated with presences of greater risk for cardiovascular disease. Otherwise, arcus senilis in old people is not directly linked with high cholesterol.
Arcus senilis is common in people as they age. As a matter of fact, almost everyone will eventually get arcus senilis. Studies show that nearly 100 percent people over the age 80 have arcus senilis. It is most common in men. Those with a family history of high cholesterol are likely to have arcus senilis.
As a person ages, the blood vessels in the eyes become permeable or widen. This allows the fats such as cholesterol to be deposited within the cornea. These fats can come from a diet when a person eats food high in fats. The fats also may come from the liver as the liver produces it.
Arcus senilis often be seen with white or grey opaque ring around the iris. Most often it affects both sides of the eyes. Sometimes, it may only affect one eye. Arcus senilis usually begins as a short arc of colour along the top and bottom of the cornea. Over time, the arcs grow and connect to form a complete ring around the cornea. Apart from the ring that develops, a person with arcus senilis does not have any other symptoms.
To diagnose arcus senilis, doctors usually review a patient’s medical history, family history and physical exam emphasising the eye exam. Slit lamp examination is usually used to get better images of the cornea. Often, patients are referred to an ophthalmologist for further evaluation. Blood tests may be requested by doctors to evaluate the fat levels. This is especially true in arcus senilis in young people.
Since arcus senilis does not cause any symptoms besides the appearance of the ring, the patient typically does not need treatment. However, if there is other underlying disorder to be the cause for the arcus senilis such as hypercholesterolemia, patients are recommended to get treatment to treat the condition such as lifestyle modifications or medications if needed.
Arcus senilis should not be confused with cataracts. Cataract is an eye disorder causing eyesight problems due to the cloudy lens. In elderly, the protein inside of the once clear lens breaks down and creates clumps which are seen as cloudy eyes. This is a normal process due to ageing and it happens gradually. While it is true that both arcus senilis and cataract is a condition that is common in older adults or elderly, there are big differences between the two. Arcus senilis does not affect eye vision while cataracts do cause blurry vision. Arcus senilis develop within the iris and around the cornea whereas cataracts develop within the lens.
It can be concluded that arcus senilis refers to the grey or bluish white ring around the cornea. It is caused by the deposited fats, mostly cholesterol. Arcus senilis is not a concern in those aged 40 and above as it is a result of the ageing process. This eye condition does not cause vision impairment. Treatment is not needed unless there are underlying conditions such as high levels of fats in blood. Treatment aims to lower the high cholesterol and the risk for cardiovascular diseases. Treatment can be from a diet low in saturated fats, high in vegetables and fruits and last but not least, lifestyle modifications such as more physical exercise and quitting unhealthy habits such as smoking and drinking excessive alcohol. Medications may be prescribed by doctors in certain cases.