Eyes are an effective tool for communication and are called windows to our feelings and thoughts. They can also indicate the state of our health.
Rajammal G, 72, lives in Coimbatore, Tamil Nadu. Chores at home and taking care of her family dominate her daily routine. She often delays her meals beyond her normal hour to complete her house work. “Sometimes, I get engrossed in work and forget to take my medicines or drink enough water,” she says. Her poor routine of eating and medication had already led to diabetes.
One day while on a morning walk, she ran into her neighbour who pointed to Rajammal’s eyelids and asked her about them. She checked the eyes when she went home and was surprised to see a couple of yellow patches around her eyelids. “Until then I had not noticed the patches under my eyes,” Rajammal recalls.
Eyes and diabetes
The yellow streaks did not hurt but Rajammal got worried and consulted an eye specialist. She learnt that her condition is called xanthelasma. Yellow plaques on or near the eye form generally due to obesity and diabetes, and in the case of Rajammal,
She says she now follows a healthy routine, eats on time, and maintains her body weight and blood sugar level with walking and medication.
What is xanthelasma?
The name xanthelasma comes from the Greek words xanthos meaning yellow and elasma which refers to the reflection of a beaten metal plate.
The yellow growths are the subcutaneous (or below the skin) plaque formations of fat or cholesterol. The spots are soft to touch and commonly seen around the eyes – on the inner side of the upper eyelids but sometimes the lower eyelids.
The causes
“Xanthelasma is primarily linked to increased levels of lipid [fat] and triglycerides in the bloodstream,” says Dr Dinshaw A. Dastoor, consultant ophthalmic surgeon, Holy Family Hospital, Bandra, Mumbai.
Xanthelasma is more likely to affect people with conditions such as diabetes, low thyroid levels, low HDL (high-density lipoprotein) levels, inflammatory skin disorders, increased body weight, and those who consume excessive alcohol and fatty diet.
“Xanthelasma can be an indicator of heart issues, too,” says Dr Syed Moosa, ophthalmologist, from Ecares Eye Hospital, Chennai, Tamil Nadu.
Dr Dastoor says, “They remain flat or pop up over the skin but are harmless. [The condition] is commonly found in elderly people and can either [remain so] or slowly increase in size over the years.”
Lifestyle management
Dr Moosa says cholesterol levels can be managed by following some amount of daily physical activity such as exercising or walking. One should also reduce eating foods rich in fats and fried foods.
Dr Dastoor emphasises the importance of reducing lipid levels to manage xanthelasma with medicine. He adds, “Xanthelasma by itself is not a severe health issue but mostly related to cosmetic concerns. The lesions can subside with time.”
Xanthelasma treatment
Treatment of xanthelasma depends on the intensity of the growths. Doctors can surgically remove the affected skin over the eyelids. Laser therapy is an option for people who do not want invasive or surgical procedures. “Chemical peels are used for cosmetic purposes to remove the fatty deposits over the skin,” says Dr Moosa.
According to the American Academy of Ophthalmology, people who undergo cosmetic surgery may initially have positive outcomes. However, there may be scarring and changes in skin colour after surgery.
Xanthelasma may reduce in size and become less prominent when lipid level reduces. Likewise, there are high chances of its recurring when cholesterol levels are not managed well.
Though xanthelasma is a benign condition, the yellow deposits are a reminder to manage our cholesterol levels and other systemic conditions.
