What You Need to Know About Fluorescein

What You Need to Know About Fluorescein

Fluorescein sodium is a synthetic chemical compound commonly used by ophthalmologists in diagnosing a wide variety of eye problems. As a "fluorophore," it possesses the ability to re-emit light so as to expose foreign bodies in the eye or to detect any damage to the cornea when used topically.

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In Fluorescein angiography testing, fluorescein is used to highlight blood vessels in the eye's two back layers, the retina and the choroid. This serves to verify proper blood flow, to diagnose various eye diseases, or to determine how effective eye treatments already administered have been.

In angiography tests, injectable rather than topically applied fluorescein is used, and a mydriatic camera photographs the vascular structures in the back of the eye, which have been made more visible by the injected fluorescein dye.

The Use of Fluorescein in Diagnostic Testing

Ophthalmologists, including retina specialists and some multi-specialty practices, rely on fluorescein angiography tests to diagnose eye disorders, confirm such diagnoses, determine appropriate treatments, and monitor the effectiveness of treatments and surgeries.

The basis of the diagnoses gained through these tests is the condition of the blood vessels and the rate of blood flow found to exist in the back of the eye.

If blood vessels are of a normal size, are not malformed, and do not gather in blockages or escape through leakage points, then all is well. If, however, any abnormalities are detected in the photograph, their nature and location will also be discovered, and an accurate diagnosis will be achievable.

Diseases and conditions that fluorescein angiography testing frequently reveal include:

Macular degeneration

Diabetic or hypertensive retinopathy

Vascular occlusions

Intraocular inflammations or tumors

Microaneurysms

Blockage of the arteries

Various cancers

Swelling of the optic disc

The Ongoing "Strength War"

Injectable fluorescein is sold in 10% and 25% concentrations, and there is an ongoing debate concerning which strength is the better one to use.

Some will argue that since the 10% option is diluted in a relatively larger 5ml vial, it will cause fewer side effects. Others, however, reason that since the 25% dosage comes in a smaller 2ml vial, less substance injected into the body will reduce side effects.

The fact is, though, that no studies have proven either concentration to be superior to the other. Thus, in practical terms, the use of 10% or 25% strength solutions is purely a matter of preference.

A similar debate over whether the dark or light version of fluorescein was superior. This led to four options being supported by different physicians: 10% dark, 10% light, 25% dark, and 25% light.

The dark version has now been discontinued, so the debate has at least been simplified somewhat.

Stocking Up for Angiogram Testing

Fluorescein angiography, or "angiogram" tests, are very commonly administered to eye patients whose vision is showing signs of weakening, making it important to keep inventory well stocked to avoid patient flow disruption. CMS will reimburse you close to $110.00 per eye to perform this test.

Companies like Accutome specialize in producing angio packs for ophthalmologists' offices and ophthalmology training centers. These packs contain the necessary elements involved in administering the test, including:

  1. Syringe
  2. Needle
  3. Alcohol prep pads
  4. Adhesive Bandage
  5. Infusion set
  6. Vial of fluorescein, either 10%-5ml or 25%-2ml strength

Conclusion

Since first introduced in the 1960's, fluorescein angiography testing has become standard in ophthalmologist circles, and it has enabled them to better diagnose and treat a multitude of eye problems.

Prevention or delay of vision loss and improved eyesight-quality are the results.

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