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Related Experiment Video

Updated: Feb 8, 2026

Establishing a Severe Corneal Inflammation Model in Rats Based on Corneal Epithelium Curettage Combined with Corneal Sutures

Establishing a Severe Corneal Inflammation Model in Rats Based on Corneal Epithelium Curettage Combined with Corneal Sutures

Published on: November 22, 2024

Corneal staining: do we really understand what we are seeing?

Philip B Morgan¹, Carole Maldonado-Codina

¹Eurolens Research, Faculty of Life Sciences, The University of Manchester, Manchester, United Kingdom.

Contact Lens & Anterior Eye : the Journal of the British Contact Lens Association

|February 3, 2009

Summary

Sodium fluorescein is a key tool for assessing ocular surface health. However, its clinical use relies more on intuition than scientific evidence regarding corneal fluorescence mechanisms.

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Area of Science:

Ophthalmology
Optometry
Biomedical Optics

Background:

Sodium fluorescein (fluorescein) is extensively used to evaluate ocular surface integrity.
Its effectiveness stems from fluorescent properties and high visibility at low concentrations.
Clinical interpretation of ocular surface fluorescence is influenced by factors like fluorescein concentration, light source wavelength, and filter use.

Purpose of the Study:

To critically evaluate published literature on cellular mechanisms of corneal surface fluorescence.
To investigate three potential mechanisms: surface pooling, cellular uptake, and paracellular ingress of fluorescein.
To highlight the gap between clinical practice and evidence-based understanding of fluorescein's interaction with the ocular surface.

Main Methods:

Literature review of published studies on corneal surface fluorescence.
Analysis of factors affecting ocular surface fluorescence.
Evaluation of cellular mechanisms: surface pooling, uptake, and ingress.

Main Results:

Ocular surface fluorescence is affected by multiple factors including fluorescein concentration, layer thickness, light excitation wavelength, and barrier filters.
Three cellular mechanisms—surface pooling, uptake by cells, and ingress around cells—are proposed to explain corneal fluorescence.
Current clinical understanding of fluorescein's role in assessing corneal integrity is based on assumptions rather than robust scientific evidence.

Conclusions:

The clinical application of fluorescein for ocular surface assessment lacks a strong evidence base regarding underlying cellular mechanisms.
There is a need for further research into the fundamental interactions between ocular surface cells and fluorescein.
Prioritizing research in optometry and ophthalmology is crucial to advance the scientific understanding of corneal surface fluorescence.