Safety of Fluorescein :
Topical, oral, and intravenous use of fluorescein can cause adverse reactions including nausea, vomiting, hives, acute hypotension, anaphylaxis and related anaphylactoid reaction, cardiac arrest, and sudden death. Intravenous use has the most reported adverse reactions, including sudden death, but this may reflect greater use rather than greater risk. Both oral and topical uses have been reported to cause anaphylaxis, including one case of anaphylaxis with cardiac arrest (resuscitated) following topical use in an eye drop. Reported rates of adverse reactions vary from 1% to 6% The higher rates may reflect study populations that include a higher percentage of persons with prior adverse reactions. The risk of an adverse reaction is 25 times higher if the person has had a prior adverse reaction. The risk can be reduced with prior (prophylactic) use of antihistamines and prompt emergency management of any ensuing anaphylaxis. A simple prick test may help to identify persons at greatest risk of adverse reaction.
Simple side effects:
- Nausia
- Vomiting
- Some kind of pain in the hand
- Yellow colored discoloration of urine
- Blurring of vision and some dazzle from the camera’s flash
- The dye can tint your skin a slight yellow
Management of simple hazards:
Most people do not experience any side effects apart from blurring of vision and some dazzle from the camera’s flash.The nausea usually is transient and subsides quickly. Hives can range from a minor annoyance to severe.
A single dose of antihistamine may give complete relief.
The dye can tint your skin a slight yellow colour and your urine can turn bright yellow, both of which will fade within 24 hours.
You should avoid exposure to direct sunlight during this time.
If the dye leaks outside the vein it may cause temporary pain.
This can be relieved by cold compression.
Drinking plenty of water during this time will help to flush the dye out of your system
More complex side effects:
- Extravasation and local tissue necrosis
- Inadvertant arterial injection
- Vasovagal reaction (circulatory shock, myocardial infarction)
- Allergic reaction, anaphylaxis (hives and itching, respiratory problems,laryngeal edema, bronchospasm)
- Nerve palsy
- Neurogenic problems (tonic clonic seizures)
- Thrombophlebitis
- Pyrexia
- Death
Management of complex hazards:
Anaphylactic shock and subsequent cardiac arrest and sudden death are very rare but because they occur within minutes, a health care provider who uses fluorescein should be prepared to perform emergency resuscitation.
