https://youtu.be/GLpCMFtxF5M

1. Remove contact lenses

• Fluorescein will permanently stain contacts. They shouldn’t put them back in for a few hours.

2. Anesthetize the eye

• Have the patient pull down their lower lid to expose the conjunctiva.
• Give 1-2 drops of proparacaine or tetracaine into the lower lid of each affected eye while the patient looks up.

3. Get the fluorescein strip wet

• Use either a saline flush or your anesthetic drops.
• You only need to get it slightly wet.

4. Apply dye

• Have your patient pull down their lower lid.
• Touch the wet paper to the conjunctiva.
• Use a thin layer of dye.
  • If the dye floods their eye, blot it away with a tissue.

<aside> ❗

Be careful, the dye can stain clothing.

</aside>

5. Turn the lights off. Turn your blue light on.

• Ideally, use the slit lamp’s blue light to examine their eye under magnification.
• You can also use a handheld Wood’s Lamp.

6. Examine the eye for abnormalities

• Fluorescein will mainly show you corneal pathology.
  • Conjunctiva sometimes has mucus that picks up stain, but this usually isn’t clinically relevant.

Abnormal Findings on Fluorescein Exam: