Fluorescein Eye Staining: Supplies and Procedure

00:01 So you want to make sure that you wash your hands and obtain all your supplies.

00:06 And position your patient.

00:08 If you have a slit lamp, that is great.

00:11 Most of the time in primary care you will not.

00:14 So you will have them positioned laying back on the exam table.

00:19 These are the supplies you're going to need.

00:21 You're going to need the fluorescein stain strips which we have here.

00:25 You're going to need non preservative artificial tears.

00:29 Or you could also use sterile saline.

00:32 You're going to need your ophthalmoscope for you to be able to use because you need the cobalt blue light. You need protective eyewear which for today I'm using my glasses.

00:41 If you wear glasses, that's sufficient.

00:44 You're going to need just regular clean gloves.

00:47 You're going to need tissue paper because there will be some tearing.

00:51 And sometimes you have to use topical anesthetic drops.

00:54 But that's not always needed.

00:58 You're actually going to prepare the fluorescein stain strip by moistening it with a sterile saline. You're going to ask the patient to look up as you gently pull down their eye, lower lid of their eye.

01:11 You're going to touch and moisten the strip to the lower conjunctiva, and then you're going to ask the patient to blink their eyes several times to distribute, and then you're going to wait 1 to 2 minutes for optimal staining.

01:25 This is just a picture of what it would look like.

01:27 But we're actually going to see that here in a few minutes.

01:31 You're going to examine the entire cornea.

01:34 You want to do that with using the cobalt blue light.

01:37 You will actually have to dim your lights in your exam room to be able to have sufficient darkness to do this. You want to do it in a systemic way.

01:46 So you're going to think of the eye as a clock and start at the 12:00 position.

01:52 You want to document the location, the size, the patterns. They're going to be different patterns depending on how the abrasion took place. So if somebody has got a corneal abrasion due to a contact that's going to be more centrally located.

02:08 If somebody's got a corneal abrasion because something's gotten up like a piece of dirt or debris is getting up in the eyelid, that's going to look like more of a scratch.

02:18 And then you sometimes have just the regular cornea abrasion that looks like an ulceration on the cornea itself. Then you want to make sure that you irrigate the eye with artificial tears to prevent them from getting a conjunctivitis related to that.

02:36 They may steal throughout the day when they wipe their eyes of tears, may still have a little of that fluorescein stain, so tell them that it could look kind of green to orangey colored.

02:47 So they need to make sure that the patient is aware of that.

02:51 Again, patient education will be specific to what they need to know and their treatment afterwards. It will only take a few minutes for some of the stain to absorb or be washed away when you use your wash.

03:04 And then again, as a reminder, let them know that it may look yellow before it completely goes away.