Ophthalmic Dyes

1. OPTHALMIC DYES

2. Introduction
 Dyes are used as Both diagnostic and therapeutic
aid.
 The use of diagnostic dyes Represent one of the
most Efficient, Objective, non invasive and directly
visible means Of identifying and tracking ocular
structures.

3. Types of dyes
1. Fluorescein
2. Rose Bengal
3. Lissamine green
4. Trypan blue

4. Fluoresciscein
 It was synthesized by Baeyer in 1871
 Fluorescein strip, each containing 0.6mg to 1mg of
the dye
 1% to 2% solution also available
in a bottle form.

5. Fluorescein
Properties :
•Orange, water soluble dye that adheres to basement membrane and can therefore highlight
areas of epithelial breakdown
Fluorescence is the ability of a molecule to absorb light of a lower wavelength and emit light
of a higher wavelength. In case of fluorescein, the molecule absorbs light in the blue spectrum
(490nm); and emits yellow-green light of a higher wavelength (530nm).

6.  Examination with Fluorescein 1% on the slip lamp with cobalt
blue light.

7. Uses:
 corneal epithelial Defects and corneal urlcers.
 Fundus fluorescence angiography (FFA)
 Fluorometer
 Tear film break up time
 Diagnosis of dry eye disease
 Applanation tonometry

8. Rose Bengal
 Brownish red powder , available in stripes, water soluble material.
 Rose bengal belongs to the class of organic compounds called xanthene.
 It will cross the cell membranes of dead cells or degenerated cell, but not
living cells

9. Properties:
1. Stains dead tissues
2. Antiviral activity
3. Stains mucus threads and corneal filaments.
4. It suggests deficiency of tear components like mucin and albumin
5. Available as strips and solution
6. Usually seen with white light and also with green filter

10. Uses:
 Conjunctival staining
 Diagnosis or corneal disease
 Diagnosis of meibomian gland dysfunction
 Corneal staining for Superficial punctate keratitis

11. Advantages:
 Superior to other stains for early detection of ocular surface disorders.
 Has some amount of anti-viral activity
 Disadvanyages:
 Studies have shown higher degrees of ocular toxicity than other vital dyes,
which is further worsened on light exposure.
 It is very irritating as specially in tear deficient eyes and therefore high degree
of patient discomfort.

12. Rose Bengal and Lissamine green strips.

13. Lissamine green
Properties :
 High affinity for staining dead and degenerated cells.
 Lissamine green has a peak absorption at the red end of the visible
spectrum (630nm)
 Preferred dye for staining bulbar conjunctiva.

14. Uses:
 Diagnosis of dry eye disease
 Acidic, synthetically derived food dye
 To make sure proper fitting of contact lens, and to look for any contact
lens induced conjunctival staining.

16. Advantages:
 The impregnated strips cause no ocular discomfort and can be used in
1% solution.
 When it comes to liquid formulations, lissamine green is preferred over
rose Bengal.
 Less degree of ocular toxicity
 Important in staining conjunctiva In superior limbic keratoconjunctivitis.
 Less irritating as compared to rose bangal

17. Disadvantages:
 large amount of stain is required as compared to fluorescein.
 At concentration of 2% and above patients discomfort starts to set in.
 It is not contact lens compatible, therefore, after use in contact-lens
wearers, irrigate the eyes with saline.

19. Trypan blue
 It is an azo dye
 Used to quantify dead cells
 live cells have an intact cell membran, trypan blue cannot penetrate cell
membrane of live cells and enter the cytoplasm
 In dead cells trypan blue passes through porous cell membrane and enter into the
cytoplasm, therefore dead cells appear
as distinctive blue colour under a microscope.

20. Uses :
 To stain anterior capsule of the lens during cataract surgery
 To stain decemet’s membrane in decemet’s stripping endothelial
keratoplasty (DSEK)
 To stain the tanon’s capsule after enucleation surgery
 For posterior segment surgeries, to stain the ERM

22. Concentration:
1. Anterior capsule staining – 0.06%
2. Posterior segment surgery – 0.15%
3. Enucleation surgery for tenon’s capsule – 0.06%
Advantages:
 Capsule takes up the stain immediately after it comes into contact with the eye
 Does not damage corneal endothelium
 Had been proven safe in pediatrics cateract surgery

23. Disadvantages:
 Caution used in pregnant and lactating women is required since large IV
doses have been found
 Use of the dye with hydrophilic acrylic is not recommended since there is
a chance of permanent staining of IOL
 This stain usually disappears in One week to 10 days.

24. Thank you !