Professional Reference articles are designed for health professionals to use. They are written by UK doctors and based on research evidence, UK and European Guidelines. You may find one of our health articles more useful.
- Use - tear film assessment, identification of corneal epithelial defects/corneal disease and perforation (Seidel test).
- Action - absorbs light in the blue wavelength and emits green fluorescence.
- Administration - a single drop is sufficient.
- Additional information - remember to warn patients that their eye will look yellow but that this readily wears off. They may also find that handkerchiefs stain yellow for several hours after they blow their nose. It stains contact lenses.
- Apply concentrated fluorescein (eg 2% solution or directly from a moistened fluorescein strip) over the suspect area of the anaesthetised cornea, whilst observing the site with a slit lamp.
- If there is a leak, the fluorescein dye appears as a bright green fluid oozing from the orange dye concentrate.
- Use - in eye units to perform fundus angiography.
- Administration - intravenous: it remains largely intravascular and circulates in the blood stream. Patients are monitored for allergic reactions during and after the procedure.
- Contra-indications - renal impairment and allergy to fluorescein.
- Side-effects - discolouration of the skin (yellow tinge) and urine, vomiting, itching, sneezing, vasovagal syncope, allergic reactions including anaphylaxis (1 in 1,900: severe, 1 in 220,000: fatal).
- Use - retinal angiography. Provides a better visualisation of the choroidal (rather than retinal) vasculature. In addition to visualising choroidal neovascularisation, it may also be helpful in assessment of inflammatory disease and choroidal tumours.
- Administration - intravenous: remains largely intravascular.
- Contra-indications - pregnancy, renal impairment, iodine allergy.
- Side-effects - nausea and vomiting, sneezing and pruritus, staining of stool, vasovagal syncope and severe anaphylaxis (1 in 1,900).
Rose Bengal 1%
- Use - detection of corneal and conjunctival damage (dessication or devitalised tissue, eg good for diagnosis of keratoconjunctivitis sicca).
- Action - stains damaged conjunctival and corneal cells.
- Additional information - this should only be administered after applying topical anaesthetic, as it stings and may cause local irritation on application; advise patients of temporary coloured staining of the eye. The dye needs to be washed out afterwards.
Further reading and references
Summary of Product Characteristics, fluorets; Fluorescein sodium. Chauvin Pharmaceuticals Ltd: electronic Medicines Compendium. Last updated September 2007.
Moorfields Manual of Ophthalmology
The Wills Eye Manual (4th ed) 2004
Denniston AKO, Murray PI; Oxford Handbook of Ophthalmology, Oxford University Press, 2009
I recently went to a retinal specialist because I was getting some flashes now and then and a lot of floaters and she told me I had a retinal tear that actually had tried to repair itself but said...rose912910
Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.