Confocal Microscopy in Ocular Argyrosis

PURPOSE: To identify the presence of silver deposits in the cornea using a new-generation confocal microscopy technique. METHODS: Case report. RESULTS: A 70-year-old man, who had been a jeweler for many years, was referred to our center for assessment of corneal opacity and ocular pigmentation. Slit-lamp examination revealed grayish, dense confluent deposits in the central and peripheral cornea, deep stroma, and Descemet's membrane. On confocal microscopy, we observed typical images of hyperreflective keratocytes across the entire stromal surface and two hyperreflective plaques coinciding with areas of metal deposition, one at Descemet's membrane and the other at Bowman's membrane. This last deposition site has not been previously identified in vivo by confocal microscopy. CONCLUSIONS: Confocal microscopy is a useful tool for the diagnosis of corneal argyrosis because it allows the in vivo visualization of silver deposits at different corneal levels.