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diagnostic stains Flashcards

(41 cards)

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1
Q

name 3 diagnostic staines

A
  • fluorescein sodium
  • rose bengal
  • lissamine green
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2
Q

which stain will you use to see things on the cornea

A

flourescein

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3
Q

which stain will you use to see things on the conjunctiva

A

rose bengal and lissamine green

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4
Q

which 2 ways can flourescein be used

A
  • topically
    or
  • injected systemically for flourescein angiography
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5
Q

what is always at hand when doing flourescein angiography and why

A

defibrillator because it can cause a cardiac arrest

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6
Q

explain why flourescein is not a true stain

A
  • it colours the tear film
  • the tear film does not invade intact corneal epithelium (i.e. it can’t pass through the cornea unless it has an abrasion and thats when flourescein enters it)
  • lipid membrane impermeable to water soluble polar water molecules
  • epithelial damage means flourescein can gain access to deeper layers
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7
Q

what spectrum of absorbed energy maximally excites flourescein molecules

A

light thats absorbed maximally between 485 - 500nm (blue)

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8
Q

what nm of light does flourescein emit

A

between 525 - 530nm (green)

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9
Q

what wavelength of light does the burton lamp emit

A

305 - 410nm

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10
Q

what wavelengths do some RGPs absorb light between

A

315 - 400nm

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11
Q

what wavelength of light does the blue filter on the slit lamp emit

A

390 - 410nm

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12
Q

list 6 uses of flourescein

A
  • assessment of corneal integrity (trauma, disease, contact lens a/c)
  • rigid contact lens fitting
  • contact tonometry
  • TBUT
  • lacrimal patency
  • lacrimal drainage
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13
Q

how is lacrimal drainage assessed with flourescein

A
  • px to blow nose and check if tissue is orange
  • if not orange then means theres a blockage in the puncta
  • can also monitor the amount of flourescein that is still in the eye so can check if conjunctiva still has flourescein which means it still hasn’t drained away
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14
Q

what are the 2 contraindications of flourescein sodium

A
  • known sensitivity

- dont put in with soft cl’s

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15
Q

what is the caution of the multi dose bottles of flourescein

A
  • contamination problems in hospitals in the 1950’s
  • flourescein is used on damaged cornea
  • pseudomonas has an affinity for flourescein
  • this progresses rapidly and can cause corneal perforation within 48 hours
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16
Q

how rapidly can pseudomonas progress and cause corneal perforation/ulcers

A

within 48 hours

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17
Q

what 2 forms of packaging is flourescein available in, what are the doses and what is the storage requirement

Study These Flashcards
A
  • minims 1% and 2%
  • flourescein impregnated strip 1mg
  • store below 25 degrees celsius
18
Q

what 4 properties are thee about flourescein minims

Study These Flashcards
A
  • orange-yellow
  • slightly alkaline
  • contains buffer to stabilise solution
  • may be combined with anaesthetic
19
Q

what is rose bengal a derivative of

20
Q

what structures does rose bengal stain

Study These Flashcards
A
  • devitalised epithelial cells of cornea and conjunctiva

- stains mucous strands

21
Q

what type of effect does rose bengal have

22
Q

rose bengal _________ on instillation, especially in ______ ______ conditions

Study These Flashcards
A

rose bengal stings on instillation, especially in dry eye conditions

23
Q

rose bengal may cause _____________ staining

Study These Flashcards
A

rose bengal may cause punctate staining

24
Q

rose bengal has a _________ effect on human _________ epithelial cells, enhanced by ____________ ___________

Study These Flashcards
A

rose bengal has a toxic effect on human corneal epithelial cells, enhanced by light exposure

25
what forms of packaging and dosage has rose bengal been available in
- 1% minims (not commercially available) | - ophthalmic strips 1.3mg
26
list 5 conditions where rose bengal is useful
- keratoconjunctivitis sicca - dendritic keratitis - neuroparalytic keratitis - exophthalmos - pressure areas due to contact lens wear
27
what form of packaging and dose is lissamine green available in
ophthalmic strips 1.5mg
28
what are the actions of lissamine green similar to
rose bengal
29
list 5 ways in which lissamine green differs from rose bengal
- stings less - less toxic - no anti viral effects - staining effect lasts longer than rose bengal - it does not stain healthy cells like rose bengal does
30
how are the actions of lissamine green similar to rose bengal
like rose bengal it binds to severely damaged cells and is easier to view against lighter irises
31
when should you observe your staining after instilling lissamine green and why
1-4 minutes - if observe too soon, staining pattern won't have developed - if observe too late, some of the staining pattern may have faded away
32
what illumination must you begin with when observing lissamine green and why
start off with low illumination as high illumination will bleach out the appearance of some staining
33
what can be used when observing staining with lissamine green that will help
red filter wratten no. 25
34
there is some evidence to suggest that early signs of ______ ______ disease is more ____________ with lissamine green compared to ______________
there is some evidence to suggest that early signs of dry eye disease is more visible with lissamine green compared to flourescein
35
for the evaluation of staining, can use charts e.g. __________ grading scheme, but _____________ may be poor
for the evaluation of staining, can use charts e.g. oxford grading scheme, but repeatability may be poor
36
list 5 other stains which are not used commercially
- alcian blue - trypan blue - bromothymol blue - methylene blue - tetrazolium and iodonitrotetrazolium
37
what does aclian blue stain
mucus
38
what does trepan blue stain
mucus and dead cells which have undergone structural changes
39
what does bromothymol blue stain
degenerate and dead cells, mucus used to investigate damage by chemical agents
40
what does methylene blue stain
bacterial stain that will also stain nerve tissue
41
what does tetrazolium and iodonitrotetrazolium stain
tetrazolium stains degenerate cells (not living or dead), staining of tumours and assessing corneal grafts

Therapeutics (19 decks)

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