Multimodal ocular imaging in diagnosis and management of occupational ocular argyrosis

Occupational ocular argyrosis is a rare disorder associated with accumulation of silver in the eye due to its occupational exposure. A 39-year-old male patient, a silver utensils polisher for the past 30 years, presented with bilateral gradual diminution of vision (presently 20/200) for 2 years. His serum silver levels were raised and ocular examination revealed bilateral greenish brown corneal deposits and complicated cataract. Anterior segment optical coherence tomography (OCT) and confocal microscopy suggested deposition of silver in various corneal layers. Multifocal electroretinogram showed a generalized decrease in sensitivity of P1 waves. Increased internal aberrations on aberrometric profile favoured phacoemulsification followed by intraocular lens implantation in both eyes. Postoperatively, the visual gain of 20/20 and normal fundus picture on indirect ophthalmoscopy, macular OCT, and fundus autofluorescence favored good prognosis in both eyes.