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Fluorescein is a diagnostic contrast agent particularly used in various ophthalmic procedures, such as checking for any corneal or vessel abnormalities. The application of fluorescein also extends to bioimaging whole anatomic structures and even further to cellular components in immunohistological staining. This article outlines the indications, mechanism of action, adverse event profile, and contraindications for fluorescein to guide the healthcare team in evaluating ophthalmic abnormalities, infection, and pathophysiology, among other conditions. Objectives: Identify the mechanism of action of fluorescein. Describe the possible adverse effects of fluorescein. Review the appropriate monitoring for patients receiving fluorescein. Summarize interprofessional team strategies for improving care coordination and communication to advance fluorescein and improve outcomes. Access free multiple choice questions on this topic.

Fluorescein toxicity is low. Proper doses of epinephrine and antihistamines can manage cases of significant hypersensitivity after flushing the affected area with plenty of water. Prevention of anaphylaxis is possible by providing a minimal dose of fluorescein to determine if a minor reaction would occur. If enough fluorescein is issued intravenously, precaution is necessary for nursing mothers because another route of excretion is through human milk, causing it to turn yellow.[10]

Because fluorescein administration is for diagnostic purposes, its use is most commonly by specialists, especially ophthalmologists, and surgeons, as well as optometrists, but it is also used by general practitioners, including physicians, nurse practitioners, and physician assistants. Nurses and/or medical assistants may also assess the proper dosage for the desired procedure. Not all health professionals readily operate with a fluorescent agent. Nurses can assist in the procedure via preparation, monitoring for adverse effects, and post-procedural care. Interprofessional coordination between the various members of the healthcare team will result in optimal results when using fluorescein for diagnostic purposes, which in turn can lead to appropriate therapeutic intervention and improved patient outcomes. [Level 5]