The corneal irony – Diagnostic dilemma in a case of suspected corneal argyrosis

A 46-year-old alcoholic male, with an occupation of polishing silver utensils for the last 6 years, presented for routine refraction. On slit lamp examination, diffuse brown pigmentation involving all layers of the cornea was found in both eyes, with the left eye being more affected; the rest of the ocular examination was normal. The ultrasound of the abdomen revealed mild hepatomegaly, normal liver function tests, and an elevated serum ferritin level. Hemochromatosis detection HFE Genotyping showed a H63D heterozygote mutant. This is a unique case of bilateral diffuse brown corneal pigmentation with a typical occupational history but without any specific systemic association or history of traumatic hyphema, retained intraocular iron foreign body, or raised intraocular pressure.