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Rose Bengal and Fluorescein Staining
PUPOSE To eva luate the integrity of the cornea.
INDICATIONS
Ophthalmic dyes are used when slit lamp eva luation of the cornea indicates that the corneal epithelium may be disrted．This procedure is also indicated when the patient has signs or symptoms suggesting corneal disease．
ADDITIONAL EQUIPMENT
·Sodium fluorescein strips.
·Rose bengal strips．
·Sterile saline solution．
STEP-BY-STEP PROCEDURE
1．Wet the end of a fluorescein or rose bengal strip with a drop of sterile saline solution．Fluorescein and rose bengal may be instilled in the eye simultaneously．
2．Instruct the patient to look ．Pull down the lower lid and touch the moistened end of the strip to the patient’s inferior bulbar or palpebral conjunctiva as shown in Figure 5-l0．
3．Instruct the patient to blink several times to spread the dye over the corneal and conjunctival surfaces．
4．Reposition the patient in the slit lamp．
5．Set the illumination arm 30°from the straight ahead position．Adjust the slit to a wide parallelepiped and set the magnification to the medium setting．
6．Insert the cobalt blue filter if using fluorescein dye．Rose Bengal stain is observed without the use of filters．
7．Scan the cornea and conjunctiva looking for areas of staining．Fluorescein staining appears bright green when viewed with the cobalt blue filter．Rose bengal staining appears deep pink in white light．Carefully note the location and pattern of staining．
RECORDING
·The results for this procedure are recorded in the slit lamp recording section under “cornea．”
·Record for each eye separately．
·Indicate the ophthalmic dye used(NaFl or RB)．
·If the results are normal，record “no staining．”If there is staining, indicate the amount and the pattern of the staining．Illustrations are extremely helpful(see Figure 5-11)．
EXAMPLES
·0D 0S
no staining with RB Cornea mild punctate staining with
RB inf．cornea
·OD 0S
large area of coalesced Cornea no staining with NaFl
staining with NaFl，
central cornea |
