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Snyder C. Solution Interaction with the Ocular Surface: The Significance in Making the Grade. Clinical & Refractive Optometry, 2005; 16:5, 134-140. Copyright Mediconcept 2005.

Bergmanson J. Interpretation of Corneal Staining on your Patient and in the Literature. Nordic Vision 6, 2006, 8-9

Ward K. Superficial Punctate Fluorescein Staining of the Ocular Surface. Optometry and Vision Science; 2008; 85:1, 8-16

A natural phenomenon
Some degree of corneal staining is widely accepted as normal owing to the natural phenomenon which occurs through continuous physiological regeneration of corneal epithelial cells and therefore occurs occasionally in virtually everyone.1,2 Corneal staining is also a common clinical observation in contact lens wearers, although often low level and clinically insignificant (≥ grade 1).3

References

  1. Bergmanson J. Interpretation of Corneal Staining on your Patient and in the Literature. Nordic Vision 6, 2006, 8-9
  2. Snyder C. Solution Interaction with the Ocular Surface: The Significance in Making the Grade. Clinical & Refractive Optometry, 2005; 16:5, 134-140. Copyright Mediconcept 2005.
  3. Nichols K. et al. Corneal Staining in Hydrogel Lens Wearers. Optometry and Vision Science, 2002; 79,1; 20-30


Corneal staining

Corneal staining is an important component of the contact lens examination and the use of topical dyes such as sodium fluorescein is one of the most simple and routinely used techniques.1,2 Since the late 19th century, it has been recognised that application of such dyes to the ocular surface will stain devitalized corneal cells resulting in increased areas of fluorescence in the presence of damage or disease.2 Corneal staining continues to be used as a clinical procedure to observe the integrity and vitality of the epithelial cells of the corneal surface.3

References

  1. Nichols K. et al. Corneal Staining in Hydrogel Lens Wearers. Optometry and Vision Science, 2002; 79,1; 20-30
  2. Ward K. Superficial Punctate Fluorescein Staining of the Ocular Surface. Optometry and Vision Science; 2008; 85:1, 8-16
  3. Snyder C. Solution Interaction with the Ocular Surface: The Significance in Making the Grade. Clinical & Refractive Optometry, 2005; 16:5, 134-140. Copyright Mediconcept 2005.


A natural phenomenon

Evidence suggests that staining is a prevalent normal phenomenon in the general population1 and a reflection of normal epithelial physiology. There are two independent epithelial cell functions that naturally occur to maintain a healthy epithelium.2

  1. Programmed cell death (apoptosis) is a normal important part of continual turnover of corneal epithelial cells where surface cells die2
  2. Continuous regeneration of new cells are generated from the underlying basal layer through normal cell division and complete the cycle2

References

  1. Ward K. Superficial Punctate Fluorescein Staining of the Ocular Surface. Optometry and Vision Science; 2008; 85:1, 8-16
  2. Snyder C. Solution Interaction with the Ocular Surface: The Significance in Making the Grade. Clinical & Refractive Optometry, 2005; 16:5, 134-140. Copyright Mediconcept 2005.


Incidence

Studies have estimated corneal staining to occur in 4% to 79% of the general (non contact lens wearing) population.1-6 Amongst the contact lens wearing population staining is up to 56% although mainly low level and clinically insignificant.7 Wearers with mild to moderate staining can normally continue to wear contact lenses without intervention.8

References

  1. Norn MS. Micropunctate fluorescein vital staining of the cornea. Acta Ophthalmol 1970;48: 108-18.
  2. Schwallie JD, McKenney CD, Long WD, McNeil A. Corneal staining patterns in normal non-contact lens wearers. Optom Vis Sci 1997;74:92-8.
  3. Korb DR, Korb JM. Corneal staining prior to contact lens wearing. J Am Optom Assoc 1970;41: 228-32.
  4. Caffery BE, Josephson JE. Corneal staining after sequential instillations of fluorescein over 30 days. Optom Vis Sci 1991;68: 467-9.
  5. Josephson JE, Caffery BE. Corneal staining characteristics after sequential instillations of fluorescein. Optom Vis Sci 1992;69: 570-3.
  6. Dundas M, Walker A, Woods RL. Clinical grading of corneal staining of non-contact lens wearers. Ophthalmic Physiol Opt 2001;21: 30-5.
  7. Nichols K. et al. Corneal Staining in Hydrogel Lens Wearers. Optometry and Vision Science, 2002; 79,1; 20-30
  8. Bergmanson J. Interpretation of Corneal Staining on your Patient and in the Literature. Nordic Vision 6, 2006, 8-9

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