DISCONTINUED can be used as a diagnostic agent when superficial conjunctival or corneal tissue change is suspected - Lissamine Green is a vital stain which stains membrane degenerate cells, dead cells and mucus and replace Rose Bengal - similar to RB the Lissamine is not very visible therefore it is recommended a red filter used as a barrier filter on slit lamp - do not sting the eye like Rose Bengal - 100 single strips CE marked

The response of our CE marked Lissamine Green strips (I-Dew GREEN) in the ESCRS 2017 has been hugely encouraging. As discussed in many of the ESCRS sessions and presentations this year, the following clinical use makes it highly desirable:  Lissamine green is the preferred dye for staining the bulbar conjunctiva and can be used to detect early dry eye. Conjunctival staining is useful for evaluating both dry eye patients and contact lens wearers. In contact lens patients, circum-limbal staining observed with lissamine green may be an indicator of contact lens induced conjunctival staining (CLICS) indicating that the lens is too tight or has a sharp edge design. The patient may need to be refit into a different lens with a flatter base curve or a different edge design. When a lens is too tight, the mechanical force of the lens edge may cause an indention in the conjunctiva, which may be observed by pooling of fluorescein or lissamine green in the indentation. A patient having CLICS is usually asymptomatic and the ocular surface may otherwise be clear; however, the consequences of continuous mechanical friction in the circum-limbal area are unknown. In patients who present with dry eye symptoms in the absence of dry eye findings, lissamine green can be used to evaluate the superior and inferior lid margins for lid wiper epitheliopathy. It is also a useful dye for evaluating herpetic lesions associated with the herpes simplex virus and neoplastic lesions, as well as for diagnosing keratoconjunctivitis sicca (KCS). A differential diagnosis for KCS is of particular importance because patients with Sjögren s syndrome, tested objectively by the presence of xerostomia and KCS, have a nine times higher prevalence of autoimmune thyroid disease. References: 1) Uchiyama E, Aronowicz JD, Butovich IA, McCulley JP. Pattern of vital staining and its correlation with aqueous tear deficiency and meibomian gland dropout. Eye Contact Lens. 2007 Jul;33(4):177-9. 2) Garofalo R, Ramsey A. Going green to evaluate contact lens fit. CL Spectrum. 2010;25(5):34-7. 3) Norn M. Vital staining of the cornea and conjunctiva. Acta Ophthalmol.1962;40:389-401. 4) Korb DR, Herman JP, Blackie CA, et al. Prevalence of lid wiper epitheliopathy in subjects with dry eye signs and symptoms. Cornea. 2010 Apr;29(4):377-83.