Ocular surface staining for suspected corneal or conjunctival tissue change
One strip moistened with 1 or 2 drops of sterile isotonic saline or irrigating solution, excess shaken off, touched to the conjunctiva or fornix, followed by several blinks
Ophthalmic strips, 1.3 mg per strip, dispenser carton of 100
Mechanism of Action
The label describes a vital stain that marks the nuclei and cell walls of dead or degenerated corneal and conjunctival epithelial cells and the mucus of the precorneal tear film. In vitro it also stains healthy cells, including rabbit corneal epithelium, rapidly, dose dependently and predominantly in the nucleus unless mucin or albumin blocks it, so staining indicates poor protection of the surface by the tear film rather than loss of cell vitality.
Warnings & Precautions
Epithelial toxicity: Staining is not inert. Cultured cells including rabbit corneal epithelium lost vitality after exposure, with immediate morphologic change, loss of motility, detachment and cell death, and the effect was augmented by light exposure.
Viral culture interference: Topical application reduced surface herpes simplex titers a million-fold in the mouse herpetic keratitis model, with a 50% inhibitory dose of 16 mcg/mL in vitro, so diagnostic use before viral culture may preclude a positive result; the same authors discourage using this dye to grade keratitis in antiviral trials. Fluorescein had no significant effect on viral replication.
Package sterility: Contents may not be sterile if the individual strip package has been damaged or previously opened.
Common Side Effects
Ocular: Stinging on instillation, more intense and longer lasting than with lissamine green; mean sensation on a 0 to 5 scale 4.6 versus 2.4 in 12 keratoconjunctivitis sicca patients and 2.5 versus 1.4 in 8 subjects with normal surfaces, both differences significant, using 1% solutions.
Ocular, dye mixtures: Moderate to marked discomfort from a 2% fluorescein plus 1% dye mixture in 14 dry eye subjects, the most efficacious of the 16 solutions tested for combined corneal and conjunctival staining.
Pregnancy & Lactation
Limited data; potential risks to the fetus not well established
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Mechanism of Action
Pregnancy & Lactation
Pediatric Use