CL Staining

Question 1

What dyes are available?

Answer 1

Sodium fluorescein
Rose bengal
Lissamine green

Question 2

What can be the cause of staining (generally)?

Answer 2

Mechanical damage
Exposure
Metabolic causes
Toxic
Allergic
Infectious

Question 3

What is the management of FB staining?

Answer 3

No lenses until resolved
Remove FB or refer for removal
Give px artificial tears for sx relief
Monitor until resolved
Replace lens if damaged

Question 4

How can you tell the difference between RGP cleaner/peroxide toxicity and CL sol toxicity?

Answer 4

RGP/peroxide: unilateral
Sols: bilateral

Question 5

What is the management of acute toxicity staining?

Answer 5

Remove lens
Irrigate eye
Monitor
Educate px

Question 6

What is the management of chronic toxicity staining?

Answer 6

Replace lens
Replace/change solution
Monitor

Question 7

What is the cause of SICS (solution-induced corneal staining)?

Answer 7

PHMB in sols attaches to lens deposits, causing inflammed cornea
Not true staining - fluorescein attaching to preservatives

Question 8

How should SICS be managed?

Answer 8

Rub and rinse compliance
Change sols to preservative free or peroxide
Change lenses to DDs

Question 9

What causes 3 and 9 o’clock staining?

Answer 9

Exposure:
RGP wear - lifts lid away from ocular surface causing dry spots
OR Incomplete blinking

Question 10

How should 3 and 9 o’clock staining be managed?

Answer 10

Refit lenses to a bigger diameter
Use lubricants