You’ve been to the optometrist for your annual / biannual eye test and you’ve been told you have arcus senilis or some other condition you’ve never even heard of before. Should you worry?
What is Arcus anyway?
Arcus Senilis is a very common and harmless condition that occurs in many people from middle age to advancing age. It looks like a white or grey ring near the edge of your cornea (the clear window at the front of your eye). The ring consists of cholesterol and lipid (fat) deposited within the cornea.
Do I need to worry?
No. Studies have found no links between arcus and a general risk of heart disease or high cholesterol. Arcus is more visible against the background of a brown iris, compare to a paler blue iris. You may have had it for years and never even noticed it! Arcus is very common, affected around 60% of those between 50 and 60 years of age and almost 100% of those over 80. The best thing is that this condition has no symptoms and requires no treatment. The only cause for concern is if you have arcus in only one eye, when it can indicate a problem with your carotid artery. Fortunately, this occurs very rarely. If arcus presents at a young age (under 40) you may be referred for a blood test to check your lipid levels.
What is Crocodile Shagreen?
This condition is not nearly as common as arcus senilis, but it is often seen during routine eye examination. Pictured above left, crocodile shagreen is a benign condition of the cornea, where the collagen fibres that make up the cornea degenerate, usually with age. Its name comes from ‘shagreen’, a type of rough leather made from shark crocodile skin, because of the similarity in appearance or pattern of this condition. It does not affect the vision and requires no treatment. Your optometrist may mention it to you during the course of your regular eye test, but it is no course for concern. It occurs to some degree in about 10% of adults.
What about Xanthelasma?
These are yellowish lumps under the skin near the inner corners of your eye. They can be both upper and lower (although you may only have one or the other).
The yellow areas have clearly-defined edges and are caused by deposits of cholesterol under the skin. Xanthelasma occur more frequently with age and are usually harmless and require no treatment. If you notice them, you should see your optometrist to rule out other, more sinister conditions that may have a similar appearance (such as eyelid tumours). You may be referred to have your cholesterol levels checked – although this condition is often seen in people who have normal cholesterol levels.
Not happy about the appearance of these little guys? If they are of cosmetic concern, you can elect to see a surgeon to discuss having them removed. This is a straightforward procedure but may leave a small scar or pigment, so it’s important to listen to your surgeon’s advice. Most xanthelasma are small and don’t cause any significant cosmetic concern.
There are many variations on the normal eye, especially as we age. Having a regular eye examination (every 2 years between the age of 40 and 65, and every year after that, or according to your optometrist’s advice) will pick up these changes as they occur and the appropriate diagnosis can be made.