Several other external manifestations of hyperlipidaemia are more non-specific but should, nonetheless, alert the clinician to the possibility that disorders of lipoprotein metabolism may have occurred. These include the presence of xanthelasma and corneal arcus. Early corneal arcus is seen superiorly and inferiorly in the eyes and later becomes totally circumferential (Fig. 6.24). Arcus occurs fairly frequently in the elderly (arcus senilis). Its presence before the age of fifty warrants evaluation of plasma lipids and lipoproteins.
