Causes of a Blue Ring Around the Eye

Can corneal arcus predict heart disease?

Perhaps you've noticed some people have a gray, white, or bluish circle around all or part of their iris (the colored part of the eye).

Sometimes referred to as "ring around the pupil," this condition is known as corneal arcus. More specifically, it is called arcus senilis in people in their 60s or older and arcus juvenilis in younger people.

Corneal arcus may appear as an arc above or beneath the cornea or form a ring around the cornea. While it is often considered benign (harmless), some evidence suggests that it may be predictive of heart disease in younger people.

Arcus senilis

Afrodriguezg / Wikimedia Commons

This article explains the two types of corneal arcus, their causes, treatment, and when to consult a healthcare provider if you think you might have the condition.

What Is Corneal Arcus?

Corneal arcus is a condition common in older adults in which deposits of fats and cholesterol around the outer edge of the iris cause a bluish, whitish, or light-gray ring. Corneal arcus occurs in almost all people above age 80. It happens as a typical part of aging.

There are two types of corneal arcus: arcus senilis and arcus juvenilis.

Arcus Senilis

Arcus senilis is common among people who are in their 60s and older. The whitish arc is caused by the deposit of fat (lipids) around the cornea.

It is associated with hypercholesterolemia (elevated cholesterol), high alcohol intake, and smoking. Discoloration caused by arcus senilis does not affect vision or harm the eye.

Corneal arcus is more prevalent in men than in women and in Blacks than in Whites. It becomes more common as all people age.

Historically it was thought that the presence of corneal arcus was a predictor of cardiovascular disease regardless of age; however, current data has disputed this belief.

Arcus Juvenilis

Colored rings around the iris that begin to appear in childhood or early adulthood are called arcus juvenilis.

A 2015 study showed that corneal arcus is associated with a higher risk of cardiovascular disease in patients with familial hypercholesterolemia. Talk to your healthcare provider if you’re under age 40 to 50 years old and notice symptoms of corneal arcus.

Many ophthalmologists tell people under age 50 with corneal arcus to get their blood tested to check for high cholesterol and other lipid-related abnormalities.

What Causes Corneal Arcus

Corneal arcus is caused by the leaking of lipoproteins—which include cholesterol—from the capillaries surrounding the cornea into the cornea itself. The deposit is made up primarily of “bad” (LDL) cholesterol.

How Is Corneal Arcus Diagnosed?

Corneal arcus is diagnosed with a physical examination of the eye by an optometrist or ophthalmologist using a lighted scope called a slit lamp.

How Is Corneal Arcus Treated?

Corneal arcus doesn’t affect a person’s vision or cause anything more than cosmetic concerns, so it isn't treated.

However, if you have corneal arcus and are under 50 years old, or if the ring appears only in one eye, you may have an underlying condition. In this case, you may need a lipid screening to determine if you have high cholesterol and/or high triglyceride levels that require treatment.

If the ring is present only in one eye (unilateral arcus senilis), it may indicate a problem with the carotid artery and heart disease.

In these cases, your healthcare provider will work with you to find and treat the underlying condition that’s causing the corneal arcus.

When to See Your Healthcare Provider

Arcus senilis is essentially a harmless condition in older people. So, too, are some changes in eye color. This tendency occurs early in life too: For example, a baby's eye color can change several times before they reach 3 years old.

Other changes in eye color should be checked by an optometrist or ophthalmologist:

  • If the whites of your eyes have turned yellow, you may have jaundice, a condition associated with liver problems.
  • Red eyes may be related to a subconjunctival hemorrhage. This is when a blood vessel breaks in the eye. It could be a symptom of diabetes, hypertension, or leukemia.
  • Red spots could be a symptom of sickle cell disease or a benign or cancerous tumor.
  • Conjunctivitis ("pink eye") is a highly contagious infection of the eye that can cause itching and pain.
  • Whitening or discoloration over your pupil can be a sign of cataracts.

Summary

A condition fittingly named "ring around the pupil" has two different names. It's known as arcus senilis in people in their 60s and older and arcus juvenilis in younger people. The condition doesn't cause pain or affect vision, but it could be a risk of heart disease in people younger than 50 years old.

7 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
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  3. Schou AL, Mølbak ML, Schnor P, Grønbæk M, Tolstrup JS. Alcohol consumption, smoking and development of visible age-related signs: a prospective cohort studyJ Epidemiol Community Health. 2017;71(12):1177-1184. doi:10.1136/jech-2016-208568

  4. Moosavi M, Sareshtedar A, Zarei-Ghanavati S, Zarei-Ghanavati M, Ramezanfar N. Risk factors for senile corneal arcus in patients with acute myocardial infarction. J Ophthalmic Vis Res. 2010;5(4):228–231.

  5. American Academy of Opthalmology. What is arcus senilis?

  6. Ogura M, Hori M, Harada-Shiba M. Association between cholesterol efflux capacity and atherosclerotic cardiovascular disease in patients with familial hypercholesterolemia. ATVB. 2016;36(1):181-188.doi:10.1161/ATVBAHA.115.306665

  7. American Academy of Ophthalmology. Why are my eyes changing color?

By Troy Bedinghaus, OD
Troy L. Bedinghaus, OD, board-certified optometric physician, owns Lakewood Family Eye Care in Florida. He is an active member of the American Optometric Association.