Localized argyrosis 58 years after strabismus surgery

Background: A pigmented episcleral lesion may have several etiologies. We d escribe the rare occurrence of a localized argyrosis secondary to former st rabismus treatment. History: A 70-year old female patient was referred to our clinic for diagno sis and treatment of a pigmented episcleral process near the insertion of t he left lateral rectus muscle which was noticed on a routine control by her ophthalmologist. The patient was free from ocular symptoms. There was a hi story of strabismus surgery on the left eye at the age of twelve. Due to th e suspicious appearance of the lesion the possibility of a conjunctival mal ignant melanoma was considered. A ultrasound exam could not exclude this su spicion and therefore a biopsy was performed. Silver deposits and rests of a suture could be found. Conclusion: Silver deposits are a rare cause of a pigmented localized episc leral lesion. Several possibilites of silver contamination in our patient a re discussed. The most likely explanation is the use of silver containing s uture material in strabismus surgery performed 58 years ago. A localized ar gyrosis secondary to past strabismus surgery should therefore be included i n the differential diagnosis of a pigmented episcleral lesion.