A patient is found to have corneal arcus on PE. What is the likely diagnosis?

• A. Hyperlipidemia
• B. Hypercholesterolemia
• C. Hyperglycemia
• D. Hypertension

Answer: (B)

Corneal arcus is a lipid-rich ring at the edge of the cornea, formed by cholesterol-containing deposits in the corneal stroma near the limbus. When you see this on exam, it most strongly points to elevated cholesterol levels, especially in younger patients where it can indicate familial hypercholesterolemia or significant hyperlipidemia. In older individuals, a similar arc can be a benign age-related change (arcus senilis), so the patient’s age matters for interpretation. This finding doesn’t relate to hyperglycemia or hypertension, which don’t typically produce corneal arcus. So the best-supported diagnosis linked to corneal arcus is hypercholesterolemia.