Arcus juvenilis
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Contributor: Gordon K. Klintworth
Arcus juvenilis (arcus lipoides, arcus senilis) is a white ring due to lipid deposition in the peripheral cornea that occurs with aging. The opacification often appears in the upper and lower parts of the cornea and may form a complete ring. Although arcus senilis is often a manifestation of aging, individuals <50 years of age may be affected, especially if they have elevated cholesterol levels and are smokers. Hyperlipidemia is often associated and the presence of arcus lipoides in a young person alerts the astute clinician to the systemic disorder of lipid metabolism and justifies an investigation of serum lipids. Sudanophilic lipid deposits in Descemet membrane, Bowman zone and in a wedge-shaped portion of the peripheral corneal stroma. Phospholipids and noncrystalline cholesterol deposit in the peripheral cornea and adjacent sclera. It appears as a deep, often incomplete yellowish-white ring, with a sharp outer margin and a poorly defined inner margin. It involves all layers of the cornea except for the corneal epithelium. The deposition is most prominent in Descemet membrane and least prominent in the midstroma.