Arcus Senilis

PLAB 2 CaseBank
1

Where you are:
You are an FY2 in the GP practice.

Who your patient is:
Amanda Wright, aged 69, has come for a follow up

Other information about the patient:
She had blood test done a week ago which showed the following results
FBC: Normal
LFT: Normal
Lipid profile: Normal

What you must do:
Talk to the patient and address concerns

Patient information:

  • Amanda had regular blood test last week.
  • Today she has come for follow up of her results
  • Comment: “Doctor I have white rings in my eyes”
  • She noticed white rings in both eyes 4-5 days ago after she started wearing her glasses.
  • She is concerned it might affect her vision.
    – What caused it?
    – Will it affect my vision?

Approach

GRIPS

Explain the results

  • All the test have come back normal
  • Which is good news

Ask for concern

  • Is there anything that concerns you at all?

Ask about white rings in the eyes

  • When did you notice it?, one eye or both eye?
  • Any pain?
  • Any problem with vision? Do you use glasses? How long?
  • How did you notice it?
    - Do you have any medical conditions?
    - Do you take any regular medications?

PMAFTOSA
ICE
Psychosocial impact

Examination: Observations & Examinations of eyes

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Diagnosis:
Arcus Senilis

  • This is a grey or white ring that is visible at the front of your eyes. (cornea)
  • It is also known as corneal arcus.
  • It is common in older people, usually due to ageing.
  • It can be caused by high cholesterol, but your cholesterol levels are normal
  • It is, therefore only age-related.

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Management:

  • Does not need any treatment.
  • It is not harmful.
  • Advise to keep healthy, eating balanced diet.
  • Offer leaflet.

https://www.osmosis.org/answers/corneal-arcus

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