Introduction

Lissamine green and rose bengal are diagnostic dyes commonly used to detect devitalized tissue in the cornea and conjunctiva.  As they both have similar action, lissamine green is often selected over Rose Bengal as Rose Bengal is thought to sting more upon instillation.

Indications

1. Dry eyes
2. Herpes simplex

Contra-Indications

Allergy to lissamine green or rose bengal

Materials

1. Lissamine green or rose bengal sterile strip
2. Sterile saline

Setup

1. Open up the sterile strip, and place one drop of sterile saline on the dye end of the strip.
2. Shake away excess fluid
3. Place the broad end of the strip against the inferior palpebral conjunctiva for a second or two.
4. Instruct the patient to blink several times
5. Wait for several minutes
6. Examine, using a parallelepiped beam with white light, the conjunctiva and cornea to identify the presence of staining.
7. Grade and record the staining as appropriate (typically as negative stain, “TR”, “1+”, “2+”, “3+” or “4+” staining along with the specific tissue stained; i.e., 3+ lissamine green stain, temporal bulbar conjunctiva)

Results

Presence of staining indicates devitalized tissue, and can in turn indicate a dry eye condition or the presence of herpes simplex.

References