Purpose: To report a case of presumed corneal argyrosis associated with sliver nitrate-coated cosmetic soft contact lens wear.
Methods: A 67-year-old woman wore silver nitrate-coated occlusive soft lenses for 17 years for the management of intractable diplopia. Slit-lamp examination revealed a diffuse blue-gray deposit that was characteristic of corneal argyrosis just anterior to Descemet membrane. Confocal microscopy, anterior segment optical coherence tomography, and noncontact specular microscopy were performed.
Results: Confocal microscopy showed hyperreflective granules in Bowman layer, deep stroma, and Descemet membrane. The granules were below the resolution of anterior segment optical coherence tomography. Confocal and specular microscopy showed an abnormal reflection from the region of Descemet membrane. Central corneal endothelial cell density was 2560 cells per square millimeter.
Conclusion: Presumed corneal argyrosis can occur after long-term use of silver nitrate-coated contact lenses.
* A case study is presented involving a male jeweler with corneal argyrosis, showing small whitish-gray deposits observed through biomicroscopy and confocal microscopy.
* The patient experienced significant contrast sensitivity impairment in low light, which suggests that testing could identify retinal issues before structural changes are observable.
Occupational ocular argyrosis is a rare disorder associated with accumulation of silver in the eye due to its occupational exposure. A 39-year-old male patient, a silver utensils polisher for the past 30 years, presented with bilateral gradual diminution of vision (presently 20/200) for 2 years. His serum silver levels were raised and ocular examination revealed bilateral greenish brown corneal deposits and complicated cataract.
Exposure to silver-containing compounds can result in reversible discoloration of the skin, presenting as an irregular brown or black macule, which can have a clinical appearance similar to melanoma. Both the clinical scenario and the histopathology are unique. Silver nitrate darkens with exposure to light, and the area can appear to change over time.
Purpose: To highlight the novel application of anterior segment optical coherence tomography (AS-OCT) to detect corneal silver deposition in a case of ocular argyrosis.
Methods: This is a case report and review of the literature.
Results: A 67-year-old man with a 30-year history of chronic occupational exposure to silver-halides secondary to photographic film manufacturing presented with significant ocular argyrosis.
Colloidal silver used as a suspension for (alternative) therapeutic purposes or silver exposure due to environmental or working conditions can lead to irreversible deposits of silver granules in the skin (bluish-gray hue of the skin), mucosa, cornea, retina and internal organs. Silver-induced discoloration of the conjunctiva should therefore be taken into account when a bluish-gray discoloration raises the suspicion of conjunctival melanoma.
