Rose Bengal Staining of the Ocular Surface and the Diagnosis of Dry Eye

Abstract

SUMMARY Since the pioneering study published in 1933 in which Sjögren described rose bengal staining of the exposed interpalpebral zone of the eye as being a characteristic sign of tear deficiency and speculated that the stained cells consisted of dead or devitalized cells, positivity for this staining pattern has been used as a criterion for the diagnosis of dry eye. Material and Methods: Rose bengal solution is instilled into the lower conjunctiva sac. After 15 seconds, the conjunctiva is examined by light passed through a green filter. Rose bengal stain is assumed to demonstrate ocular surface damage by being taken up into dead and degenerate cells. The intensity of staining of the interpalpebral zone is quantified into grades ranging from 1 to 3. Application: The use of rose bengal staining of the ocular surface as a diagnostic criterion for dry eye requires further investigation into the possible staining patterns that may result from use of this dye in view of the different etiologies responsible for this clinical condition. Further investigation is only possible following standardization of the techniques used in the test and implementation of an evaluation system that takes into consideration not only the interpalpebral zone, but the entire ocular surface. DESCRIPTORS Rose Bengal. Keratoconjunctivitis sicca. Diagnosis.