What do we really know about corneal staining?

 

Morgan 2011


 

Philip Morgan

BSc, PhD, MCOptom, FAAO

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Abstract

For decades, contact lens practitioners have reached for their stock of fluorescein to given them information about the state of the ocular surface in their patients.  We believe that the green patches tell us something about the health of the cornea and conjunctiva with the areas which are stained showing either a loss of cells or damaged cells.  Is this actually the case?


This presentation will adopt an evidence-based approach to review the use of fluorescein in contact lens practice and review its presentation, application and clinical observation.


In fact, very little is published about fluorescein use in contact lens practice, and we seem to be very reliant on clinical tuition to manage cases where fluorescein staining is observed, rather than using a more solid basis for our actions.  In fact, the term 'staining' might be incorrect, at least in some cases. It's time, therefore, to challenge received wisdom and to reconsider what we really know about corneal staining.

 

 

Learning objectives

  • To review the physical characteristics of sodium fluorescein and its optimal use in clinical practice
  • To discuss the various patterns of fluorescein staining and their interpretation
  • To present the mechanisms of ocular surface fluorescein at the cellular level
  • To review the 'solution staining debate' and what it reveals about the interaction between lenses and solutions, and the interpretation of corneal staining

 

 

Tillbaka