Arcus senilis found in a 35-year-old patient should prompt evaluation for which condition?

Arcus senilis found in a 35-year-old patient should prompt evaluation for which condition?

• A. Hypertension
• B. Diabetes
• C. Hyperlipidemia
• D. Anemia

Answer: (C)

Arcus senilis in a person under 40 points to a lipid disorder rather than aging. This gray-white ring at the corneal margin happens because cholesterol and other lipids deposit in the peripheral cornea. In younger patients, its presence is a red flag for hyperlipidemia, including familial hypercholesterolemia, which raises the risk of premature atherosclerosis. The appropriate next step is to obtain a fasting lipid panel to assess total cholesterol, LDL, HDL, and triglycerides, and to evaluate for familial hypercholesterolemia if LDL is markedly elevated or there is family history. While hypertension, diabetes, or anemia are important diagnoses, they are not the primary associations with arcus senilis in a young adult, so they’re not the most fitting explanation for this finding.

Arcus senilis in a person under 40 points to a lipid disorder rather than aging. This gray-white ring at the corneal margin happens because cholesterol and other lipids deposit in the peripheral cornea. In younger patients, its presence is a red flag for hyperlipidemia, including familial hypercholesterolemia, which raises the risk of premature atherosclerosis. The appropriate next step is to obtain a fasting lipid panel to assess total cholesterol, LDL, HDL, and triglycerides, and to evaluate for familial hypercholesterolemia if LDL is markedly elevated or there is family history. While hypertension, diabetes, or anemia are important diagnoses, they are not the primary associations with arcus senilis in a young adult, so they’re not the most fitting explanation for this finding.