Unusual reaction to fluorescein dye in patients with inflammatory eye disease

Ocular side effects attributable to intravenous fluorescein dye are not well characterized. The purpose of this report was to describe three patients with an unusual ocular reaction after the intravenous administration of fluorescein dye.

Retrospective review of the clinical and photographic records of three patients.

Each patient had some type of preexisting ocular inflammatory disease. Each patient described the subacute onset of a unilateral burning sensation and tearing several minutes after the administration of intravenous fluorescein dye. Findings included a new onset of or a worsening of unilateral conjunctival chemosis and injection in all three patients and yellowish discoloration of the conjunctiva in two patients. In each patient, the noninflamed (fellow) eye did not develop any symptoms or show any visible reaction. The symptoms and findings resolved promptly in the affected eye without specific treatment or effect on vision.

Ocular side effects of intravenous fluorescein dye can include transient symptomatic burning and tearing associated with conjunctival chemosis, injection, and yellowish discoloration. Eyes with active inflammatory diseases may be predisposed to this rare effect through an unclear mechanism.