Lidocaine/Fluorescein Health‐med (Fluorescein Sodium, Lidocaine Hydrochloride)

• Lidocaine/Fluorescein is used in ophthalmic procedures to provide topical anesthesia and to stain ocular surface lesions.
• Diagnostic corneal staining: highlights epithelial defects for visualization under cobalt blue light.
• Conjunctival staining: delineates areas of damage or foreign bodies during examination.
• Topical ocular anesthesia: numbs the cornea and conjunctiva for minor procedures such as tonometry, foreign body removal, or laser treatment.

• Lidocaine hydrochloride blocks voltage‑gated sodium channels on corneal sensory nerves, preventing depolarization and producing local anesthesia. Fluorescein sodium penetrates damaged epithelial cells, binds to plasma proteins, and fluoresces under cobalt blue illumination, allowing clinicians to identify corneal and conjunctival lesions. The combined action provides both pain relief and diagnostic staining in a single ophthalmic solution.

Common Side Effects

• Stinging or burning sensation on instillation.
• Transient blurred vision lasting a few minutes.
• Mild conjunctival hyperemia (redness).
• Temporary itching or mild allergic irritation.

Serious or Rare Side Effects

• Severe allergic reaction, including anaphylaxis.
• Persistent corneal epithelial defect or ulceration.
• Stevens‑Johnson syndrome or toxic epidermal necrolysis (very rare).
• Marked increase in intra‑ocular pressure.
• Vision loss due to corneal toxicity (extremely rare).

Before use, consider the following precautions:

• Allergy assessment: confirm no known hypersensitivity to lidocaine, fluorescein, or other ophthalmic dyes.
• Pregnancy and lactation: use only if the potential benefit justifies the potential risk, as safety data are limited.
• Contact lens wearers: remove lenses prior to administration to avoid staining and irritation.
• Repeated use: limit frequency to prevent corneal toxicity.
• Active ocular infection: avoid unless directed by a clinician.
• Store at room temperature: keep in the original container, protect from light and moisture.

Lidocaine/Fluorescein may interact with other agents as follows:

Major Interactions (Avoid)

• Co‑administration with other topical ophthalmic anesthetics: increased risk of corneal toxicity.
• Systemic lidocaine with anti‑arrhythmic drugs (e.g., amiodarone, quinidine): may potentiate systemic cardiac effects if absorbed.
• Fluorescein with photosensitizing medications (e.g., tetracyclines): may heighten ocular irritation under bright light.

Moderate Interactions (Monitor Closely)

• Beta‑blocker eye drops: may slightly reduce the anesthetic effect.
• Proton pump inhibitors: monitor systemic lidocaine levels in extensive use.
• Alcohol consumption: may enhance systemic absorption of lidocaine, requiring observation.