Topical anaesthetic + diagnostic dye Pregnancy: SPC §4.6: this combination has been used for a number of years without apparent ill-consequence.

Fluorescein with lidocaine

Brand names: Minims lidocaine and fluorescein

This is a combined topical ophthalmic diagnostic preparation pairing fluorescein, an orange dye, with the local anaesthetic lidocaine, used to facilitate examination such as applanation tonometry, foreign body removal and assessment of corneal epithelial integrity.

Auto-extracted from the source labelling — not yet independently clinician-verified. These values were distilled from the UK SPC (or the US label where noted) but have not had a clinician sign-off. Confirm against the current SmPC before prescribing.

Adult dose

Dose: One or more drops, as required

Route: Topical ocular (instilled into the eye)

Frequency: As required

SPC §4.2 gives the adult dose (including the elderly) as 'One or more drops, as required'; no maximum number of drops or dosing interval is stated. Paediatric: SPC states only 'Children: As directed by the physician' — no numeric paediatric dose is given, so none is reproduced here; verify against a children's formulary. Per SPC §4.4: the anaesthetised eye should be protected from foreign body contamination, particularly in elderly patients in whom the duration of anaesthesia may exceed 30 minutes; use with caution in an inflamed eye as hyperaemia greatly increases the rate of systemic absorption through the conjunctiva; systemic absorption may be reduced by compressing the lacrimal sac at the medial canthus for a minute during and following instillation (especially advisable in children). Source product: Minims Lidocaine & Fluorescein — the correct fixed combination for this page.

Dose auto-extracted from UK Summary of Product Characteristics (SPC) via the eMC; US FDA prescribing information (openFDA / DailyMed) — cross-check; US labelling may differ from UK — not yet clinician-verified. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

Known hypersensitivity to fluorescein
Known hypersensitivity to lidocaine or other amide-type local anaesthetics

Side effects

Allergic conjunctivitis (very rare)
Peri-orbital oedema (very rare)
Anaphylactic reaction (very rare)
Urticaria (very rare)
Rash (very rare)

Interactions

SPC §4.5: none known

Clinical monograph

How it works

Fluorescein stains areas of de-epithelialised cornea and conjunctiva and fluoresces under blue light to reveal epithelial defects, while lidocaine produces rapid surface anaesthesia by blocking neuronal sodium channels.

Prescribing in practice

This is for diagnostic use only and must never be supplied for repeated self-administration, as continued topical anaesthesia causes corneal epithelial toxicity, delayed healing and ulceration.
The anaesthetised eye loses its protective blink and corneal sensation, so it should be shielded from injury until sensation returns.
Fluorescein can permanently stain soft contact lenses, which should be removed beforehand.

Monitoring

No laboratory monitoring is required; the clinician observes the staining pattern under cobalt-blue light and confirms adequate but transient anaesthesia during the procedure.

Counselling the patient

Your eye will be numb for a short while, so avoid rubbing or touching it until normal feeling returns.
The dye may briefly tint your tears yellow-orange.
Leave contact lenses out until advised it is safe to reinsert them.

Evidence & guidelines

Combined fluorescein and local anaesthetic drops are standard adjuncts for tonometry and minor ocular procedures in routine ophthalmic and emergency practice.

Reference: Drug verified in RxNorm (NLM); confirm dosing against the manufacturer SPC (eMC). Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Curated clinical cross-links plus same-class fallbacks.

Calculators

Pathways