Optimization of anterior eye fluorescein viewing.
OBJECTIVE
To optimize anterior eye fluorescein viewing and image capture.


METHODS
Prospective experimental investigation.


METHODS
The spectral radiance of ten different models of slit-lamp blue luminance and the spectral transmission of three barrier filters were measured. Optimal clinical instillation of fluorescein was evaluated by a comparison of four different instillation methods of fluorescein into 10 subjects. Two methods used a floret, and two used minims of different concentration. The resulting fluorescence was evaluated for quenching effects and efficiency over time.


RESULTS
Spectral radiance of the blue illumination typically had an average peak at 460 nm. Comparison between three slit-lamps of the same model showed a similar spectral radiance distribution. Of the slit-lamps examined, 8.3% to 50.6% of the illumination output was optimized for >80% fluorescein excitation, and 1.2% to 23.5% of the illumination overlapped with that emitted by the fluorophore. The barrier filters had an average cut-off at 510 to 520 nm. Quenching was observed for all methods of fluorescein instillation. The moistened floret and the 1% minim reached a useful level of fluorescence in on average approximately 20s ( approximately 2.5x faster than the saturated floret and 2% minim) and this lasted for approximately 160 seconds.


CONCLUSIONS
Most slit-lamps' blue light and yellow barrier filters are not optimal for fluorescein viewing and capture. Instillation of fluorescein using a moistened floret or 1% minim seems most clinically appropriate as lower quantities and concentrations of fluorescein improve the efficiency of clinical examination.
Peterson
Rachael C
RC
Ophthalmic Research Group, School of Life and Health Sciences, Aston University, Birmingham, UK.
Wolffsohn
James S
JS
Fowler
Colin W
CW
D000328:Adult; D000869:Anterior Eye Segment / Q000033:anatomy & histology*; D005260:Female; D019793:Fluorescein / Q000737:chemistry*; D005453:Fluorescence; D015590:Fluorophotometry; D006801:Humans; D008297:Male; D011446:Prospective Studies
D019793:Fluorescein