Occupational corneal argyrosis in art silver solderers.
OBJECTIVE
To determine the value of confocal and specular microscopy in the examination of corneal argyrosis in art silver solderers.


METHODS
Six patients with corneal argyrosis underwent a complete physical and ophthalmologic examination. Specular microscopy was performed in three cases, and in vivo confocal microscopy in four cases. Ultrasound biomicroscopy and corneal topography were performed in three cases. A conjunctival specimen of one patient was examined histologically in paraffin sections.


RESULTS
Slit-lamp examination showed gray, diffuse opacities in the deep corneal stroma. Confocal microscopy showed highly reflective deposits with a granular pattern anterior to the corneal endothelium and hypereflective keratocyte nuclei with visible cytoplasm in the anterior stroma. Specular microscopy demonstrated round white bodies anterior to the corneal endothelium. Silver deposits were not found histologically.


CONCLUSIONS
Silver solderers with long-term exposure to silver compounds are at high risk of developing corneal argyrosis. We conclude that specular microscopy and in vivo confocal microscopy provided important information for the diagnosis of corneal argyrosis.
D000368:Aged; D001129:Argyria / Q000000981:diagnostic imaging / Q000473:pathology*; D003228:Conjunctiva / Q000473:pathology; D003316:Corneal Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D019781:Corneal Topography; D006801:Humans; D008297:Male; D008669:Metallurgy; D018613:Microscopy, Confocal; D008875:Middle Aged; D009784:Occupational Diseases / Q000000981:diagnostic imaging / Q000473:pathology*; D012834:Silver; D014463:Ultrasonography
D012834:Silver