1.Dr Rajvin Samuel Fluorescein

2. ` Fluorescein is a synthetic organic compound available as a dark orange/red powder soluble in water and alcohol. 3. Synthesis: It can be prepared from phthalic anhydride and resorcinol in the presence of zinc chloride via the Friedel-Crafts reaction. Other name - Resorcinolphthalein 4. Medical applications : In forensics and serology to detect latent blood stains In Microbiology To detect Leptospira strains under microscopy in Syphilis Serology (FTA-ABS Test) In dentistry - a dye applied to teeth to reveal plaque 5. Fluorescein sodium is used extensively as a diagnostic tool in the field of ophthalmology. It is applied topically in the form of a drop or it can be injected intravenously to produce a fluorescein angiogram. Topical fluorescein is useful in the diagnosis of corneal abrasions, corneal ulcers, herpetic corneal infections, and dry eye. Fluorescein angiography is used to diagnose and categorize macular degeneration, diabetic retinopathy, inflammatory intraocular conditions, and intraocular tumors 6. In ophthalmology Ophthalmic research : Intraocular dynamic studies [fluorometry] Tear film drainage studies Penetration to anterior segment structures Fluorescein angiography [in acquired macular & Retinal vascular patholgies] Staining techniques Test for dry eye Evaluation of tear drainage Applanation tonometry 7. Fluorescein angiography Photographic surveillance of passage of fluorescein through retinal and choroidal circulation Principle: A molecule is excited by light of certain wavelength to a higher energy level ,release photon then comes down to original state 2 ml of 25 % [0r] 5 ml of 10 % solution 8. 80 % protein bound and 20 % free into circulation PROCEDURE: White light from camera flash pass through blue excitation filter [488 nm ] stimulates Yellow green barrier filter [533 nm] back into camera film A red free photograph is taken at 1 second interval 5-25 secs after injection onset 9. Phases : 1 . Choroidal 2. Arterial 3. Arteriovenous [capillary] 4. Venous 5. Late [elimination] Side effects of Fluorescein: Temporary yellowing , Orange yellow urine , Nausea,vomiting ,Urticaria , Toxic neuritis ,Local tissue necrosis ,Extravasation into skin ,vasovagal reactions 10. Hypofluorescence: 1. Vascular filling defects 2.Blockage by haemorrhage RPE hypertrophy ,Hard - - exudates, Naevi ,. Hyperfluorescence: Leakage Pooling staining Transmission [window defect] 11. Staining Techniques: Seidels test for Wound leak Corneal Staining for ulcers ,other epithelial defects 12. Test for dry eye Tear break up time To test for tear film stability ,fluorescein dye is added to the eye and the tear film is observed under the slit lamp while the patient avoids blinking until tiny dry spots develop. The longer it takes, the more stable the tear film. A short tear break-up time is a sign of a poor tear film. Generally, >10 seconds is thought to be normal, 5 to 10 seconds, marginal, and