A 6-year-old child with suspected corneal abrasion: which diagnostic test is used?

A 6-year-old child with suspected corneal abrasion: which diagnostic test is used?

• A. Instillation of mydriatic drops and microscopic examination of the globe
• B. Visual acuity testing with the Snellen Chart
• C. Culture of any discharge from the eye
• D. Instillation of fluorescein dye and examination with a Wood's lamp

Answer: (D)

Diagnosing a corneal abrasion hinges on fluorescein staining visualized with a Wood's lamp. Fluorescein dye highlights areas where the corneal epithelium is disrupted, making the abrasion appear as a bright green staining under cobalt blue light or a Wood's lamp in a dim room. This quick, noninvasive test allows the clinician to see the defect even in a young child who may not cooperate with more extensive exams. Visual acuity testing alone doesn’t reveal the epithelial disruption, culture is reserved for suspected infection, and dilating/mydriatic maneuvers aren’t used to diagnose an abrasion. So, instilling fluorescein dye and examining with a Wood's lamp is the most appropriate diagnostic approach.

Diagnosing a corneal abrasion hinges on fluorescein staining visualized with a Wood's lamp. Fluorescein dye highlights areas where the corneal epithelium is disrupted, making the abrasion appear as a bright green staining under cobalt blue light or a Wood's lamp in a dim room. This quick, noninvasive test allows the clinician to see the defect even in a young child who may not cooperate with more extensive exams. Visual acuity testing alone doesn’t reveal the epithelial disruption, culture is reserved for suspected infection, and dilating/mydriatic maneuvers aren’t used to diagnose an abrasion. So, instilling fluorescein dye and examining with a Wood's lamp is the most appropriate diagnostic approach.