Optimization of anterior eye fluorescein viewing

center dot PURPOSE: To optimize anterior eye fluorescein viewing and image capture. center dot DESIGN: Prospective experimental investigation. center dot 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. center dot 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 run. 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 similar to 20s (similar to 2.5x faster than the saturated floret and 2% minim) and this lasted for similar to 160 seconds. center dot 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. (Am J Ophthalmol 2006; 142:572-575. (c) 2006 by Elsevier Inc. All rights reserved.)