Optimizing evaluation of Lissamine Green parameters for ocular surface staining.

Area of Science:

• Ophthalmology
• Ocular Surface Disease

Background:

• Lissamine Green (LG) is a gold standard for ocular surface staining in dry eye.
• Optimal parameters for LG instillation require determination for accurate examination.

Purpose of the Study:

• To determine optimal parameters for 1% Lissamine Green (LG) dye instillation in dry eye patients.
• To assess inter-observer reliability and tolerance of different LG volumes.

Main Methods:

• Prospective, observational quality improvement study involving 16 eyes from 8 dry eye patients.
• Instilled 1% LG in volumes of 5, 10, and 20 μl.
• Evaluated staining with and without a red filter using the Oxford scale; assessed inter-observer reliability.

Main Results:

• 10 μl of LG was preferred by experienced observers for ease and accuracy.
• 20 μl resulted in overflow, while 10 μl and 20 μl yielded similar scores.
• Red filter significantly improved reading scores (P<0.01); higher reliability for conjunctival vs. corneal staining.
• Highest reliability observed with 10 μl, increasing with observer experience.

Conclusions:

• 10 μl of 1% Lissamine Green (LG) provides good inter-observer reliability for ocular surface examination in dry eye.
• LG instillation is well-tolerated, and examination is facilitated by a red filter.