Following a general overview of the visible portion of the anterior segment and prior to significant manipulation of the lids, fluorescein should be instilled to measure the break-up time of the tear film (B.U.T.), look for corneal staining, conjunctival staining, and papillae.
The method of instilling fluorescein is important. The fluorescein strip should be moistened with saline (not an RGP conditioning or wetting solution). Do not touch the bottle tip to the strip. After putting a drop on the strip and the strip is sufficiently moist, shake the excess off prior to instilling the fluorescein. You do not want to add excessive solution to the eye, just the stain.
