A case report featured in the Journal of Medical Optometry detailed the rare occurrence of caruncle and conjunctival argyrosis following a patient’s chronic exposure to silver.
The case details.
The report describes a 72-year-old White man with mild foreign body sensation presented with grayish discoloration of the caruncle, plica semilunaris, inferior bulbar, palpebral, and forniceal conjunctiva of both eyes (see photo here).
The authors stated that, because this had not been noted previously, or noticed by the patient or his spouse, there was initial concern for primary acquired melanosis.
Was the patient taking any medications?
The patient reported using over-the-counter (OTC) colloidal silver eye drops for the past several months as preventative care.
What were the clinical exam details?
Per the case report:
- Anterior segment echographic exam was unremarkable
- Anterior segment optical coherence tomography (OCT) showed conjunctival epithelial hyperreflective foci (photo here)
- Conjunctival biopsy of the discolored inferior forniceal conjunctiva and episclera of the left eye showed extensive pigment deposition—consistent with silver deposits—and follicular conjunctivitis (photo here)
Did the discoloration resolve after cessation of the colloidal silver drops?
Interestingly enough, although the patient discontinued the colloidal silver eye drops, his clinical exam findings showed no change after 16 months of follow up.
Remind me, what is Argyrosis?
Argyrosis, stemming from the Greek word for silver (argyros), is a condition resulting from prolonged exposure to chemical forms of silver.
Its most notable symptom: Bluish-grey skin.
From an ocular perspective: Deposits can be seen in the conjunctiva, cornea, lens, and retina—although, unless affecting the cornea or lens, these are rarely visually significant.
So why might someone use colloidal silver drops?
Before the routine use of antibiotics, silver was used in medicine given its antimicrobial properties. Even in eye care, this was previously used to prevent neonatal eye infections.
However, with the wide availability of ocular antibiotics, the occurrence of argyrosis is much less common.