An older adult has a grey-white arc around the cornea. What is your response?

An older adult has a grey-white arc around the cornea. What is your response?

• A. "You have the beginnings of cataracts and should see an eye surgeon."
• B. "These are a normal finding in your age group and will not affect vision."
• C. "This is caused by thickening of your cornea and is probably causing some blurring of your vision."
• D. "The discolouration in your eyes is called xanthelasma and is caused by high levels of cholesterol."

Answer: (B)

An older adult with a grey-white ring around the cornea is most consistent with arcus senilis, a common, normal aging change. This lipid-rich arc forms at the edge of the cornea and usually does not affect vision. It isn’t a cataract, nor caused by thickening of the cornea, and it isn’t a sign of cholesterol plaques on the eyelids. Xanthelasma are yellow plaques on the eyelids, not a corneal ring. Reassure the patient that this finding is normal for age and will not impair vision, and consider lipid assessment only if there are other risk factors or symptoms.

An older adult with a grey-white ring around the cornea is most consistent with arcus senilis, a common, normal aging change. This lipid-rich arc forms at the edge of the cornea and usually does not affect vision. It isn’t a cataract, nor caused by thickening of the cornea, and it isn’t a sign of cholesterol plaques on the eyelids. Xanthelasma are yellow plaques on the eyelids, not a corneal ring. Reassure the patient that this finding is normal for age and will not impair vision, and consider lipid assessment only if there are other risk factors or symptoms.