Ocular Argyrosis Mimicking Conjunctival Melanoma

Abstract

Purpose Present a novel case of ocular argyrosis mimicking conjunctival melanoma. Methods A 48-year-old male career jewelry manufacturer presented with raised pigmented lesions in the inferior fornixes of both eyes. Brown-black colored, follicle-like, masses were observed in both fornixes. Results An incisional biopsy confirmed the presence of silver and the diagnosis of ocular argyrosis. Conclusion Despite its limited negative health effects, ocular arygrosis should be considered in the differential diagnosis of conjunctival pigmented lesions due to the potential for misidentification of neoplastic growth.

Arygrosis in Lens Capsule: A Case Report

“…Differential diagnostic considerations encompass alternative metallic deposition disorders, including Wilson’s disease with pathognomonic copper accumulation, ocular chrysiasis characterized by gold particle deposition, and siderosis involving iron precipitation ( 10 ). Conditions associated with abnormal ocular pigmentation, including primary acquired melanosis and malignant melanoma, require systematic exclusion ( 18 ). Pharmacologically-induced corneal deposits secondary to medications such as amiodarone and antimalarial agents may demonstrate morphologically similar presentations ( 1 ).…”

Arygrosis in Lens Capsule: A Case Report

“…Differential diagnostic considerations encompass alternative metallic deposition disorders, including Wilson’s disease with pathognomonic copper accumulation, ocular chrysiasis characterized by gold particle deposition, and siderosis involving iron precipitation ( 10 ). Conditions associated with abnormal ocular pigmentation, including primary acquired melanosis and malignant melanoma, require systematic exclusion ( 18 ). Pharmacologically-induced corneal deposits secondary to medications such as amiodarone and antimalarial agents may demonstrate morphologically similar presentations ( 1 ).…”

Subconjunctival Ocular Argyrosis following Treatment with Ruthenium 106 Brachytherapy for Choroidal Melanoma

“…It has been well established that chronic exposure to silvercontaining material can increase the risk of developing ocular argyrosis [7]; previous reports document cases as a consequence of silver ingestion [8], exposure from longstanding eyelash tint use [9,10], and occupational exposure to silver such as in metal foundry workers and jewellers [11][12][13]. Isolated iatrogenic causes have also been recorded secondary to use of silver sutures in previous strabismus surgery [14] and use of silver-containing eye drops (Argyrol) [15].…”

“…Extraocular extension of uveal melanoma can present similarly to the cases presented above; patients may present with scleral discolouration or subconjunctival pigmented lesions [7, 19]. Distinguishing features of ocular argyrosis include that the deposits tend to be grey-black, not brown, and may be more granular or “dust-like” rather than nodular extraocular tumours.…”

“…It is important to distinguish the two conditions: extra-scleral uveal melanoma has great metastatic propensity, poor prognosis, and high mortality rates [20]. In contrast, localised ocular argyrosis is of limited clinical consequence having been described as predominantly a cosmetic issue that does not result in vision loss [7, 21].…”

Black Henna Deposits Masquerading a Melanoma of the Plica Semilunaris

“…5–7 Prolonged exposure to silver-containing products may similarly result in conjunctival subepithelial silver absorption and deposition, a condition called ocular argyrosis which may also mimic a melanoma. 8…”

Arygrosis in Lens Capsule: A Case Report

“…Differential diagnostic considerations encompass alternative metallic deposition disorders, including Wilson’s disease with pathognomonic copper accumulation, ocular chrysiasis characterized by gold particle deposition, and siderosis involving iron precipitation ( 10 ). Conditions associated with abnormal ocular pigmentation, including primary acquired melanosis and malignant melanoma, require systematic exclusion ( 18 ). Pharmacologically-induced corneal deposits secondary to medications such as amiodarone and antimalarial agents may demonstrate morphologically similar presentations ( 1 ).…”

Subconjunctival Ocular Argyrosis following Treatment with Ruthenium 106 Brachytherapy for Choroidal Melanoma

“…It has been well established that chronic exposure to silvercontaining material can increase the risk of developing ocular argyrosis [7]; previous reports document cases as a consequence of silver ingestion [8], exposure from longstanding eyelash tint use [9,10], and occupational exposure to silver such as in metal foundry workers and jewellers [11][12][13]. Isolated iatrogenic causes have also been recorded secondary to use of silver sutures in previous strabismus surgery [14] and use of silver-containing eye drops (Argyrol) [15].…”

“…Extraocular extension of uveal melanoma can present similarly to the cases presented above; patients may present with scleral discolouration or subconjunctival pigmented lesions [7, 19]. Distinguishing features of ocular argyrosis include that the deposits tend to be grey-black, not brown, and may be more granular or “dust-like” rather than nodular extraocular tumours.…”

“…It is important to distinguish the two conditions: extra-scleral uveal melanoma has great metastatic propensity, poor prognosis, and high mortality rates [20]. In contrast, localised ocular argyrosis is of limited clinical consequence having been described as predominantly a cosmetic issue that does not result in vision loss [7, 21].…”

Black Henna Deposits Masquerading a Melanoma of the Plica Semilunaris

“…5–7 Prolonged exposure to silver-containing products may similarly result in conjunctival subepithelial silver absorption and deposition, a condition called ocular argyrosis which may also mimic a melanoma. 8…”

Arygrosis in Lens Capsule: A Case Report

“…Differential diagnostic considerations encompass alternative metallic deposition disorders, including Wilson’s disease with pathognomonic copper accumulation, ocular chrysiasis characterized by gold particle deposition, and siderosis involving iron precipitation ( 10 ). Conditions associated with abnormal ocular pigmentation, including primary acquired melanosis and malignant melanoma, require systematic exclusion ( 18 ). Pharmacologically-induced corneal deposits secondary to medications such as amiodarone and antimalarial agents may demonstrate morphologically similar presentations ( 1 ).…”

Subconjunctival Ocular Argyrosis following Treatment with Ruthenium 106 Brachytherapy for Choroidal Melanoma

“…It has been well established that chronic exposure to silvercontaining material can increase the risk of developing ocular argyrosis [7]; previous reports document cases as a consequence of silver ingestion [8], exposure from longstanding eyelash tint use [9,10], and occupational exposure to silver such as in metal foundry workers and jewellers [11][12][13]. Isolated iatrogenic causes have also been recorded secondary to use of silver sutures in previous strabismus surgery [14] and use of silver-containing eye drops (Argyrol) [15].…”

“…Extraocular extension of uveal melanoma can present similarly to the cases presented above; patients may present with scleral discolouration or subconjunctival pigmented lesions [7, 19]. Distinguishing features of ocular argyrosis include that the deposits tend to be grey-black, not brown, and may be more granular or “dust-like” rather than nodular extraocular tumours.…”

“…It is important to distinguish the two conditions: extra-scleral uveal melanoma has great metastatic propensity, poor prognosis, and high mortality rates [20]. In contrast, localised ocular argyrosis is of limited clinical consequence having been described as predominantly a cosmetic issue that does not result in vision loss [7, 21].…”

Black Henna Deposits Masquerading a Melanoma of the Plica Semilunaris

“…5–7 Prolonged exposure to silver-containing products may similarly result in conjunctival subepithelial silver absorption and deposition, a condition called ocular argyrosis which may also mimic a melanoma. 8…”