The fluorescein appearance test for lacrimal obstruction.

The fluorescein appearance test has been developed for the evaluation of the patency of the lacrimal excretory system. This objective test is simple, painless, physiologic, and reliable. The only materials required are 2% fluorescein, ultraviolet light, and a tongue blade. A 2% fluorescein solution is instilled in the conjunctival cul-de-sac after which the posterior oropharynx and nostrilis are examined with ultraviolet light. Over 90% of 92 eyes from 66 normal subjects gave positive results within 30 minutes and 100% gave positive results within 60 minutes. Slow appearance times can be anticipated because there appears to be a correlation between Schirmer test values and the time required for a positive fluorescein appearance test. The test proved clinically useful in evaluating patients with epiphora and in making the diagnosis of several cases of lacrimal obstruction verified by nuclear dacryocystography.