Ophthalmic Dyes.pptx

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 Fluorescein Rose Bengal Lissamine green 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 : Stains dead tissues Antiviral activity Stains mucus threads and corneal filaments. It suggests deficiency of tear components like mucin and albumin Available as strips and solution 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.

15. 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

16. 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.

17. 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.

18. 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

19. Concentration : Anterior capsule staining – 0.06% Posterior segment surgery – 0.15% 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

20. 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.

21. Thank you !