fluorescein sodium + lidocaine hydrochloride: clinical use

Prescribing considerations

• Use is diagnostic rather than therapeutic and requires appropriately trained supervision.
• Protect the anaesthetised cornea from rubbing, foreign bodies and trauma until sensation returns.
• Use caution in an inflamed or hyperaemic eye because systemic absorption may increase.
• Nasolacrimal occlusion can reduce systemic absorption, particularly in children.
• Frequent or prolonged ophthalmic local-anaesthetic use may cause corneal epithelial loss, keratitis and stromal opacity.

Contraindications and cautions

• Known hypersensitivity to fluorescein, lidocaine or another amide-type local anaesthetic.

Monitoring

• Observe for allergic ocular, skin or systemic reactions.
• Protect the cornea while sensation is reduced.
• If excess exposure or repeated use is suspected, assess the corneal epithelium and visual symptoms.

Clinical pharmacology

Lidocaine blocks sensory nerve endings to produce topical corneal anaesthesia. Fluorescein stains disrupted conjunctival or corneal epithelium and outlines some foreign bodies.

Formulation and product differences

• Clear, slightly yellow, slightly viscous sterile ophthalmic solution.
• Preservative-free single-use units.
• Excipients include povidone, hydrochloric acid and purified water.