Senile Calcific Plaque
Senile calcific plaques commonly occur in individuals older than 70 years. They appear as firm, flat, sharply circumscribed rectangular or ovoid gray scleral patches. The plaques, which appear bilaterally, are typically located anterior to the medial and lateral rectus muscle insertions in the interpalpebral fissure (Fig 8-8A). The etiology is unknown; various causes, such as scleral dehydration, actinic damage, and stress on scleral collagen exerted by rectus muscle insertions, have been proposed but not proven.
Histologic sections show that the calcium is present within the midportion of the scleral stroma. The plaque begins as a finely granular deposition but may progress to a confluent plaque involving both superficial and deep sclera (Fig 8-8B). Senile plaques may be highlighted by special stains for calcium, such as von Kossa and alizarin red.
Excerpted from BCSC 2020-2021 series: Section 4 - Ophthalmic Pathology and Intraocular Tumors. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.