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Ocular Pharmacology > Dyes > Flashcards

Dyes Flashcards

1
Q

Characteristics of fluorescein

A
  • Water soluble
  • Weakly acidic anion in alkaline solution such as
    tears
  • Maximum fluorescence at pH 8
  • Commonly available as sodium salt (NaFL)
  • Metabolised by liver
  • Eliminated in urine
  • Absorption spectrum in blood: 465 nm
  • Absorption spectrum on ocular surface: 450-493 nm (blue)
    produced through a Cobalt blue slit lamp filter
  • Emission 520 nm (yellow-green) isolated with a Kodak
    Wratten barrier filter
  • Absorption/emission spectra are dependent on the absorption spectrum, pH and concentration of the fluor; fluorescence is best at [0.1%] vs negligible at [2%]; avoid excess application of fluorescein
    *
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2
Q

Fluorescein quenching phenomenon

A
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3
Q

Fluorescein formulations with standard molecular weight topical (376kD)

A
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4
Q

Fluorescein formulations with high molecular weight (topical) (710kD)

A
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5
Q

What % of circulating fluorescein is bound to serum proteins RBCs (inactive)

A

70-85%

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6
Q

Dose of IV or oral fluorescein

A
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7
Q

Indications of topical fluorescein

A
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8
Q

Corneal abrasion vs ulcer

A
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9
Q

How does fluorescein help with dry eye assesment

A

Fluorescein pools in gaps created on the ocular surface by lost
epithelial cells following exposure-mediated damage to tight-junctions

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10
Q

Diffuse punctate keratitis

A
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11
Q

Tear meniscus height

A
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12
Q

Rigid gas permeable (RGP) contact lens fit evaluation with topical fluorescein

A

.

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13
Q

Jones I Test: Diagnosis of Tear Duct Obstruction

A
  • Jones I: fluorescein is applied to ocular surface; an anesthetized cotton-tipped swab is inserted into the ipsilateral nostril for 5 min, then evaluated for staining
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14
Q

Jones II (Irrigation) Test

A
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15
Q

Diagnosis of Epithelial Keratitis

A
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16
Q

GOLDMANN APPLANATION TONOMETRY

17
Q

Oral fluorescein

18
Q

IV fluorescein

19
Q

FLUORESCEIN ANGIOGRAPHY

20
Q

Adverse effects of topical fluorescein

A
  • Common
    • Sting & irritation
    • Redness
    • Dermatitis
  • Rare
    • Corneal hypersensitivity
    • Corneal epithelial keratopathy
21
Q

Adverse effects of IV fluorescein

A
  • Common
    • Nausea and vomiting
    • Headache
    • Tissue necrosis
    • Cutaneous reaction
  • Rare
    • Allergy including laryngeal edema
    • Cardiac arrest
    • Vagal reaction: convulsions
    • Syncope
22
Q

Contraindications of IV fluorescein

A
  • Absolute
    • History of adverse reaction to fluorescein angiography
  • Relative
    • Asthma
    • Hay fever
    • Renal failure
    • Hepatic failure
    • Pregnancy (esp. 1st trimester)

Elimination by liver and kidneys is normally complete within 24-48h

23
Q

Characteristics of rose bengal

A
  • Optimal for evaluation of conjunctiva > cornea
  • Stains mucus strands & filaments
  • An intact mucin layer blocks Rose Bengal staining of ocular surface
  • Staining of devitalized cornea and conjunctival cells is seen in regions with compromised mucin production and tear film instability
  • Absorption 545-490 nm; viewed under white light; not fluorescent
  • Viewed under white light or appears dark with green light
  • Photo-reactive
  • Antiviral properties reported for HSV-1: culture before application
  • Masked by fluorescein; best performed before applying NaFL
24
Q

Topical rose bengal

25
Q

IV rose bengal

26
Q

Adverse effects of rose bengal

A
  • Common
    • Produces a significant burning sensation; consider using an anesthetic before Rose Bengal application
  • Rare
    • Hypersensitivity
27
Q

Characteristics of lissamine green

28
Q

Lissamine green

29
Q

Diagnostics and adverse effects of lissamine green

30
Q

Double vital staining

31
Q

Surgical dyes

Ocular Pharmacology (10 decks)

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