Anterior Segment Imaging Of A Patient With Ocular Argyrosis

Ocular argyrosis is a condition characterized by bluish-grey colored conjunctivas caused by chronic topical exposure to chemical forms of silver. Depositions of silver can also accumulate in eyelid, caruncle and cornea. It is a very rare condition most commonly identified as an occupational disease in patients which are often exposed to silver compounds in their work environment. The purpose of this abstract is to present a patient with ocular argyrosis who did not have chronic exposure to silver in work environment and to elaborate anterior imaging methods of this entity. Also, our purpose is to raise awareness of this condition as a differential diagnosis in ocular and conjunctival hyperpigmentations.

Department of Ophthalmology, University hospital center Zagreb, Zagreb, Croatia

88-year-old patient was referred to our clinic for a regular checkup. He stated that he has had discoloration of conjunctivas for over 10 years withouth any changes. His examination was unremarkable except for blueish colored conjunctivas, which was most prominent in lower tarsal part, and carunculas of both eyes and bilateral corneal deposits. Upon further examination, patient stated that he has been using silver-ion containing artificial tears for 5 years 10 years ago. Anterior OCT was performed with aim to detect deposits in cornea. Anterior segment photography of both eyes was made with aim to objectify follow up of the patient. Patient has been coming for regular check-ups with anterior segment imaging in the period of two years.

Anterior OCT has shown hyperreflective deposits in Bowman’s and Descemet’s membrane of the cornea of both eyes. Anterior eye segment photography has shown dusty corneal deposits. On regular check-ups results of imaging were unchanged. In follow up period of two years no change was reported. 

Anterior OCT and anterior eye segment photography have proven to be valuable imaging methods for diagnosis of ocular argyrosis, along with clinical examination and patient medical history containing exposure to silver ions. Although ocular argyrosis usually does not cause visual impairment, continuous accumulation of corneal deposits can cause blurry vision. Furthermore, it is important to be acquainted with the diagnostic methods to make a correct diagnosis and to rule out other ocular hyperpigmentation diseases which could be potentially life threatening, such as conjunctival melanoma.