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Ocular Diagnostic Preparations

Post your experience
Fluorescein sodium1

Topical

  • Use - identification of corneal epithelial defects 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. There may also find that handkerchieves stain yellow for several hours after when they blow their nose. Stains contact lenses.

Seidel test to detect a wound leak:2

  • Apply concentrated fluorescein (e.g. 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.

Systemic

  • Use - in specialist 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.
  • Side-effects3 - discolouration of skin (yellow tinge) and urine, vomiting, itching, sneezing, syncope, allergic reactions including anaphylaxis.
Rose bengal
  • Use - detection of corneal and conjunctival damage.
  • Action - stains damaged conjunctival and corneal cells.
  • Additional information - may cause local irritation on application, advise patients of temporary coloured staining of the eye.

Document references
  1. Summary of Product Characteristics, fluorets; Fluorescein sodium. Chauvin Pharmaceuticals Ltd: electronic Medicines Compendium. Last updated September 2007.
  2. Kunimoto DY, Kanitkar KD, Makar MS; The Wills Eye Manual, 4th Edition, 2004, Lippincott, Williams and Wilkins. ISBN: 0-7814-4207-2
  3. Kanski J. Clinical Ophthalmology, A Systematic Approach, 5th Ed, 2003, Butterworth Heinemann. ISBN 0-7506-5541-0
AcknowledgementsEMIS is grateful to Dr Olivia Scott for writing this article. The final copy has passed scrutiny by the independent Mentor GP reviewing team. ©EMIS 2007.
DocID: 375
Document Version: 1
DocRef: bgp26086
Last Updated: 7 Nov 2007
Review Date: 6 Nov 2008

The authors and editors of this article are employed to create accurate and up to date content reflecting reliable research evidence, guidance and best clinical practice. They are free from any commercial conflicts of interest. Find out more about updating.

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