[Corneal and conjunctival findings in systemic silver intoxication].
BACKGROUND
Chronic silver intoxication is a rare disease and therefore the typical ocular findings may be missed. Based on a case with severe intoxication, the clinical and histological findings as well as the prognosis in argyria are presented.


METHODS
A 33-years-old-employee of a battery production plant developed a biopsy proven systemic argyria. On slit lamp examination the conjunctiva showed a dark, blue-grey discoloration in the areas of the tear flow and the small conjunctival arteries. Diffuse silver deposits were noticed on the level of Descemet's membrane without endothelial damage. Silver deposits were also visible in the trabecular meshwork. Chemical reaction of the silver particles upon exposure to UV light results in irreversible tissue discoloration. Without options for an effective treatment, early diagnosis and prevention of overexposure are most important.


CONCLUSIONS
The typical ocular findings in systemic argyria are helpful in occupational medicine for establishing the correct diagnosis.
Flögel
W
W
Augenklinik, UniversitätsSpital Zürich, CH-8091 Zürich. Walter.Floegel@usz.ch
Widmeier
S
S
Hotz
P
P
Schärer
L
L
Barthelmes
D
D
Landau
K
K
Thiel
M A
MA
D000328:Adult; D001129:Argyria / Q000473:pathology*; D003228:Conjunctiva / Q000187:drug effects* / Q000473:pathology; D003315:Cornea / Q000187:drug effects* / Q000473:pathology; D006801:Humans; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D012834:Silver
D012834:Silver