FLUORESCEIN BASIS, LIMITATIONS

AND ADVERSE EFFECTS

Prof. Assistance Hiba. M. Elawad

Sodium Fluorescein – Clinical Use
 When used as ophthalmic dye, fluorescein is in the form of 2% solution or
as 1mg flourescein-imregnated filter paper strips and is available in a single
dose sterile pipettes to prevent bacterial contamination.
Clinical use:
 Assess the integrity of the ocular surface.
 It stains any cell it enters and temporarily marks any of the damged areas.
The stain differs according to which part of the eye is affected(conjunctiva-
yellow; cornea-green; anterior chamber-green flare). Bright yellow-green
allow the detection of abrasions, ulcers and odema in the cornea and
conjunctiva resulting from trauma or infection.
 Can be used to identify foreign bodies in the eye as they will be surrounded
by a green boundary.
 Staining of the tear film allows the assessment of tear break-up time
 Tear flow and nasolacrimal duct patency.
 Measurement of IOP with applanation tonometer.
 Evaluation of contact lens fitting.
 Also used to observe corneal wound healing after cataract and glaucoma
surgery.
Terminology
Indications For Flourescein Angiography
Flourescein Angiogram
Anterior Segment Flourescein Angiography
Stimulation And Emission:
Important Properties Of Fluroescein:
Limitations:

 Fluorescein angiography has one significant limitations; it does not

permit study of the choroidal vasculature . This is because of two
reasons:
1. Melanin within the retinal pigment epithelial cells absorb light of all
wavelength in the visible spectrum and so prevents significant
fluorescence of the dye within the chorodial vasculature and also
limits its visibility.
2. The molecular weight of fluorescein (376) and its relatively poor
protein binding enables it to pass easily across the chorio-capillaries
and so does not delineate these vessels sharply.
 These limitations have been overcome to certain degree by usage of
the dye Indocyanine Green and Infrared photography.
 Other minor limitations are the risk of severe adverse reactions in
small group of patients and the inability to obtain an angiogram in
patients with a very high hemoglobin concentration or exessive serum
protein.
Characteristics Of Sodium Flourescein Dye:
Flourescein Side-effects And Adverse Reactions: