During a patient exam dentists take note of more than just the teeth. We look at facial symmetries, shape of the nose, bone structures, and the list goes on. Another important area to focus on is the appearance of the patient’s eyes.

Conditions such as cataracts usually stand out easily at speaking distances. The opacification of the lens of the eye creates the classic cloudy appearance seen below.

Maybe not as well known, and less apparent upon visual inspection, is a Corneal Arcus, aka Arcus Senilis, aka Arcus lipoides. This occurs when there is increased deposition of lipids in the periphery of the cornea¹. The term Arcus Senilis is sometimes used because it is commonly seen in the elderly². If it is found in patients under 40, it is referred to as Arcus Juvenilis. Usually, a white, grey, blue, or even yellowish ring is seen around the iris. In large study from the American Journal of Ophthalmology, it was determined that this ring around the eye can be associated with hypercholesterolemia and hypertriglyceridemia³. Another study found that it can also just be apart of the normal aging process⁴.

What Should the Dentist Do?

If you notice this during a patient exam, refer back to the medical history and confirm/ask if the patient is being treated by a physician for high cholesterol/hyperlipidemia. Again, this process can also just be apart of the aging process, ages 60-70+, so a reminder for the patient to meet with their doctor is not a terrible idea. If the condition is noted in a patient under the age of 40, this may indicate something more serious and should be referred to both the patients eye doctor and primary care physician for further evaluation.

1. Klatt, E. C., & Robbins, S. L. (2020). Robbins and Cotran atlas of pathology. Amsterdam: Elsevier.
2. Hashemi, H., Khabazkhoob, M., Emamian, M. H., Shariati, M., & Fotouhi, A. (2014). A population-based study of corneal arcus and its risk factors in Iran. Ophthalmic epidemiology, 21(5), 339–344. https://doi.org/10.3109/09286586.2014.949782
3. Chua, B. E., Mitchell, P., Wang, J. J., & Rochtchina, E. (2004). Corneal arcus and hyperlipidemia: findings from an older population. American journal of ophthalmology, 137(2), 363–365. https://doi.org/10.1016/S0002-9394(03)00902-4
4. Raj, K. M., Reddy, P. A., & Kumar, V. C. (2015). Significance of corneal arcus. Journal of pharmacy & bioallied sciences, 7(Suppl 1), S14–S15. https://doi.org/10.4103/0975-7406.155765

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