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Fluorescein is a dye which is taken up by damaged cornea such that the area appears green under cobalt blue light. [3] There is also a version that comes premixed with lidocaine. [4] [8] Fluorescein was first made in 1871. [9] It is on the World Health Organization's List of Essential Medicines. [10]
Fluorescein sodium, the sodium salt of fluorescein, is used extensively as a diagnostic tool in the field of ophthalmology and optometry, where topical fluorescein is used in the diagnosis of corneal abrasions, corneal ulcers and herpetic corneal infections.
During eye exam the defect is examined after staining with fluorescein dye. The underlying cornea has minimal inflammation. Patients with epithelial keratitis complain of foreign-body sensation, light sensitivity, redness and blurred vision. Focal or diffuse reduction in corneal sensation develops following recurrent epithelial keratitis.
Although corneal abrasions may be seen with ophthalmoscopes, slit lamp microscopes provide higher magnification which allow for a more thorough evaluation. To aid in viewing, a fluorescein stain that fills in the corneal defect and glows with a cobalt blue-light is generally instilled first. [citation needed]
The fluorescein is examined with a cobalt blue filter. At this point, the fluorescein appears green in color. Any changes in color or surface of the fluorescence area indicate the presence of corneal leakage. The test is contraindicated in obvious globe rupture, Full-thickness eye laceration, and fluorescein hypersensitivity. [1]
Fluorescein staining may be used to detect for epithelial defects, corneal infection or perforation of the cornea. [8] Tear break-up time and ocular protection index assessment can be done to reveal dry eye. Exophthalmometry can be used to measure degree of exophthalmos.
Dendritic corneal ulcer after fluorescein staining under cobalt blue illumination Adenoviral keratitis of a 24-year-old woman. The most common causes of viral keratitis include herpes simplex virus (HSV) and varicella zoster virus (VZV), which cause herpes simplex keratitis and herpes zoster keratitis (a subtype of herpes zoster ophthalmicus) respectively. [3]
Fluorescein 2% [2] is instilled into the lower fornix of patient's eye. Alternatively, impregnated fluorescein strip moistened with preservative (benzalkonium chloride) free saline solution can also be used. [6] The eye is examined under a slit lamp with a low magnification and a broad beam covering the whole cornea. The lamp is switched to a ...