Lecture 2 - DIagnostic Stains

Question 1

What 4 important topical stains are used and provides low toxicity?

Answer 1

Fluorescein, Rose Bengal, and Lissamine Green

Question 2

What are a few usages for stains?

Answer 2

Enhance contrast and view the the tissue.

Note: There is special affinity for ocular tissues and cells.

Note: Acidic and Basic - bound to irritate eye

Question 3

What natural stain is found in psudeomonus?

Answer 3

Fluroescein

Question 4

Where does fluroscein is ionized?

Answer 4

In the tears and absorb into the junctions of the cornea

Question 5

True or False. The absorption is proportional to being absorbed in blood.

Answer 5

False. 493 nm absorbption on the cornea and 465 nm in the blood

Question 6

Is the aqueous humor acid or basic?

Answer 6

Basic.

Seidel’s sign - fluorscein around the lesion will mark and let you know where the damage occurred.

Question 7

What is a ratan filter?

Answer 7

It reduces the emission to 520 nm.

Make sure to put this in front of recieving lens

Question 8

What is quenching?

Answer 8

atom or molecule, it can cause excited form into a ground state, without emitting the energy.

Thus giving you a false negative result

Question 9

What drug is least quenching?

Answer 9

Anesthetics: BAC & Benoxinate, Proparacaine and the most being tetracaine

Question 10

What gives you the false negative findings with the anaesthetics you know?

Answer 10

Tetracaine!!!!

Question 11

When fluorescein is intiated, you notice a foreign body and you know there is siedel’s sign. What does this indicate?

Answer 11

Corneal abrasion

Question 12

True or False. You must complete the evaluation of the anterior chamber before conducting the TBUT.

Answer 12

True.

Question 13

What is punctate keratitis?

Answer 13

Ulcerated eye

Question 14

If you have a pt. trying on RGP, what is good method while using a burton lamp?

Answer 14

Put wratten 47 fiter over the light source

Question 15

What is Jones test?

Answer 15

Fluorescein has been administered and the pt. is asked to blow their nose and then observe the tissue.

Question 16

When fluorescein is administered and an aneasthetic will cause _____ of IOP.

Answer 16

Underestimation

Question 17

What is the method given for angiography and there %?

Answer 17

5 ml 10% or 3ml 25% IV or 0.5% PO

Note: IV will most likely give you an adverse reaction. This occurs in the anti-cuboidal artery

Question 18

Pooling in the region of the macula, what does indicate?

Answer 18

Stargaardt’s disease and diabetic retinopathy

Question 19

What is auto fluroscein?

Answer 19

Camera technology that allows the result to be seen from the pts. own fluorescein

Question 20

What is the best type of fluorescein formulation for HMW(high molecular weight) topical?

Answer 20

Fluoresoft PF (perservative free) and Flura-Safe

Question 21

What is the shelf life for all topicals set in room temp.?

Answer 21

1 months

Question 22

What are 4 common adverse reactions for topicals of fluorescein?

Answer 22

Sting, Irritation, Redness and Dermatitis

Allergies: Asthma or Psoriasis

Question 23

Whats are 4 serious adverse reactions for topicals of fluorescein?

Answer 23

Corneal Hypersensitivity Epithelial Keratopathy, Corneal, Seizures and CNS depression

Question 24

What is the pregnancy category for fluorescein?

Answer 24

Cat. C

Question 25

What are 4 common adverse reactions for IV Fluorescein?

Answer 25

Nausea and Vomitting, Headacje, Tissue Necrosis and Cutaneous reaction

Question 26

What are 4 rare adverse reactions of fluorescein?

Answer 26

Allergy, Cardiac Failure, Vagal RXN, Conculsions, and shock

Question 27

What devitalized tissue does Rose Bengal light up?

Answer 27

Dead cells on the mucous surface

Ie. Goblet cells

Question 28

What type of light is Rose Bengal used?

Answer 28

White light or Red free (green filter)

Note: Rose Bengal is more irritating than fluorescein

Question 29

Why does Rose Bengal have a Mild Antiviral property?

Answer 29

It destroys the viral issue thus you cannot conduct a diagnostic test of the virus

Question 30

How is RBC hemolysis occur with Rose Bengal?

Answer 30

Due to the Photoreactive property of Rose Bengal, it will hemolysis the RBC, thus tissue being deprived of nourishment

Question 31

Would you give Rose Bengal to a pt.who is allergic to Iodine?

Answer 31

No.

Question 32

What are three type of health issues that can be detected by topical rose bengal?

Answer 32

Keratoconjunctivitis Sicca (KCS)
Superior Limbic Keratoconjunctivitis (SLK)
Herpes Simplex / Zoster

Question 33

What are 2 types of health issues that can be detected by IV rose bengal?

Answer 33

Argon laser photocoagulation

Metastatic melanoma

Question 34

What is an adverse effects INDICATED by the manufacturer?

Answer 34

Pronounced irritant (burns)

Question 35

What does Lissamine Green stain?

Answer 35

Mucus or devitalized tissue

Question 36

How is LIssamine Green viewed?

Answer 36

Under white light or a Red filter

Question 37

What are 3 indications of LG?

Answer 37

KCS, Superior Limbic KC and Herpes Simplex/Zoster

Question 38

What are 3 secondary effects of LG?

Answer 38

Minimal irritation, Itch and Hypersensitivity (Rare)

Question 39

What is the method of Indocyanine green used?

Answer 39

Through IV

Question 40

What is the 1/2 life of ICG?

Answer 40

2 to 3 minutes

Question 41

What is the indication of ICG?

Answer 41

Volume and release of blood through the heart

Question 42

What are 3 adverse effects of ICG?

Answer 42

N&V, Sneezing, Anaphylaxis (rare)

Question 43

What are contraindicattions of ICG?

Answer 43

Iodine or Shellfish allergy

Accumlates in the ocean and fish can accumulate high numbers, this should NOT BE ADMINISTERED in both Rose Bengal or ICG.