Miscellaneous

Question 1

Blindness is

Answer 1

Distant BCVA in the better eye worse than 3/60 or
VF less than 10° from fixation

Question 2

Fluorescein – Concentrations

Answer 2

Strips 0.6–1 mg
1–2% solution
IV 10% (5 ml) or 20% (2 ml)

Question 3

Fluorescein – Properties

Answer 3

Orange, water-soluble; adheres to basement membrane; fluoresces (absorbs 490 nm, emits 530 nm); 70% protein bound IV

Question 4

Fluorescein – Uses

Answer 4

Dry eye diagnosis, TBUT, tear meniscus height, corneal staining, ulcers, abrasions, Seidel’s test, Jones test, canaliculus trauma, applanation tonometry, FFA, contact lens fitting, intraocular vitreous staining

Question 5

Fluorescein – Advantages

Answer 5

Ready-to-use strips
no irritation ≤3%
no ocular toxicity

Question 6

Fluorescein – Disadvantages

Answer 6

Allergy risk; caution in renal failure, asthma, pregnancy; less effective for choroidal imaging

Question 7

Lissamine Green – Concentrations

Answer 7

1–3% liquid; 1.5 mg strips

Question 8

Lissamine Green – Properties

Answer 8

Acidic, synthetic; stains dead/degenerate cells, mucous strands; nuclear localization; absorbs ~630 nm; better with red-free filter

Question 9

Lissamine Green – Uses

Answer 9

Dry eye diagnosis
Sjogren’s
contact lens fit
lid wiper epitheliopathy
SLK

Question 10

Lissamine Green – Advantages

Answer 10

Minimal discomfort with strips
preferred over Rose Bengal
less toxicity
better conjunctival staining visibility

Question 11

Lissamine Green – Disadvantages

Answer 11

Discomfort ≥2%; needs larger/repeated application; not contact lens compatible

Question 12

Rose Bengal – Concentrations

Answer 12

1.3 mg strips

Question 13

Rose Bengal – Properties

Answer 13

Halide derivative of fluorescein;
stains dead/devitalized cells,
mucous strands;
highlights tear film deficiency

Question 14

Rose Bengal – Uses

Answer 14

Dry eye diagnosis, conjunctival staining, dysplastic cells, corneal staining, herpetic dendrites, SPK, eyelid staining (MGD)

Question 15

Rose Bengal – Advantages

Answer 15

Superior for early ocular surface disorder detection; some HSV-1 antiviral activity

Question 16

Rose Bengal – Disadvantages

Answer 16

Higher ocular toxicity (worse with light); stinging/burning; reduced uptake with lubricants; declining routine use

Question 17

Trypan Blue – Concentrations

Answer 17

Anterior capsule 0.06%; posterior segment 0.15%; Tenon’s capsule 0.06%

Question 18

Trypan Blue – Properties

Answer 18

Does not penetrate capsule;
stains Tenon’s capsule;
stains ERM after fluid-air exchange

Question 19

Trypan Blue – Uses

Answer 19

Anterior capsule staining (esp. poor red reflex);
DSEK; DALK donor prep;
Tenon’s staining post-enucleation;
ERM staining

Question 20

Trypan Blue – Advantages

Answer 20

FDA-approved
pre-mixed syringes
immediate capsule staining
safe for corneal endothelium
safe in pediatric cataract

Question 21

Trypan Blue – Disadvantages

Answer 21

Must wash out quickly
risk of staining IOL/tissues
caution in pregnancy/lactation
can stain hydrophilic IOL permanently

Question 22

ICG – Concentrations

Answer 22

IV: 40 mg/2 ml IV
I/O: 0.05–0.5% intraocular (ILM)
25 mg vial + 5 ml solvent = 0.5%

Question 23

ICG – Properties

Answer 23

Binds collagen IV & laminin (ILM affinity); 98% protein bound IV; does not diffuse from vessels; unstable when diluted & light exposed

Question 24

ICG – Uses

Answer 24

Anterior capsule staining
ILM visualization in vitrectomy
ICGA for CNVM, AMD, PCV, choroidal vasculopathy, posterior uveitis

Question 25

ICG – Advantages

Answer 25

Washes out quickly in cataract surgery; ICGA better tolerated than FFA; IR light penetrates pigments & opacities better

Question 26

ICG – Disadvantages

Answer 26

Needs dilution/filtration retinal toxicity may persist in vitreous seep through macular hole RPE/optic disc damage not FDA-approved for intraocular use

Question 27

ICG – Precautions

Answer 27

Inject into fluid-filled eye to reduce macular contact; IFCG preferred (iodine-free, less toxic)

Question 28

Triamcinolone Acetonide – Concentrations

Answer 28

0.1–0.3 ml of 40 mg/ml solution for vitreous staining

Question 29

Triamcinolone Acetonide – Properties

Answer 29

Synthetic, insoluble corticosteroid; white crystals in aqueous suspension; binds vitreous & ILM for contrast

Question 30

Triamcinolone Acetonide – Uses

Answer 30

Vitrectomy: settles on vitreous for removal detects vitreous in AC after capsular rent FDA-approved (Triesence) for macular edema, uveitis

Question 31

Triamcinolone Acetonide – Advantages

Answer 31

No retinal toxicity; excellent vitreous visualization in posterior surgery

Question 32

Triamcinolone Acetonide – Disadvantages

Answer 32

Persists in vitreous up to 40 days; cataract risk; IOP rise; endophthalmitis, hypopyon, pseudohypopyon

Question 33

Brilliant Blue G – Concentrations

Answer 33

0.025% for ILM staining

Question 34

Brilliant Blue G – Properties

Answer 34

Strong affinity for ILM; does not stain ERM/vitreous; enables negative staining of ERM and double staining technique

Question 35

Brilliant Blue G – Uses

Answer 35

ILM staining in posterior segment surgeries

Question 36

Brilliant Blue G – Advantages

Answer 36

FDA-approved for ILM; safer than ICG for ILM staining

Question 37

Brilliant Blue G – Disadvantages

Answer 37

Rare atrophic changes after subretinal migration; long-term toxicity not fully known