In my experience, if you ask 5 ophthalmic photographers, you will get 5 different answers, and 5 ways to do it correctly. Darrin Landry, CRA, OCT-C Bryson Taylor Inc. Ophthalmic Consultants and Training www.brysontaylor.com phone 207-838-0961 fax 207-809-4550 www.brysontaylorpublishing.com ---------------------------------------- From: "Breit, Peter" <BreitP@xxxxxxxx> Sent: Tuesday, May 21, 2013 12:58 PM To: "optimal@xxxxxxxxxxxxx" <optimal@xxxxxxxxxxxxx> Subject: [optimal] fluorescein reactions? 10% vs 25% I use AKORN 25% and have no problems with nausea unless the room is very warm and the patient is African-American or Indian. Dark or light FlSd makes no difference. 10% slower injection I use only very occasionally when I have to shoot lots of peripheral shoots (BDR) on both eyes. If you inject 5cc very fast you will get nausea almost every time, just my opinion after my 45 years of experience with this stuff. Time to retire .. Thank you friends Peter Peter L. Breit, CRA. Director Ophthalmic Services The Lankenau Hospital & Bryn Mawr Hospital 484-476-3338 484-476-8206 fax 484-437-3262 mobile page 3707 ---------------------------------------- From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of CPMC Ophthalmic Diagnostic Center Sent: Friday, May 17, 2013 4:45 PM To: optimal@xxxxxxxxxxxxx Subject: [optimal] Re: fluorescein reactions? Anecdotally, our incident of reaction is too low to statistically track. We almost never see nausea either. Personally, I'm convinced it speaks to volume of solution, and/or good patient management. Denice Denice Barsness, CRA, COMT, ROUB, CDOS, FOPS Ophthalmic Diagnostic Center CPMC Department of Ophthalmology 2100 Webster Street Suite 212 San Francisco CA 94115 (415) 600-3937 FAX (415) 600-6563 From: optimal-bounce@xxxxxxxxxxxxx [mailto:optimal-bounce@xxxxxxxxxxxxx] On Behalf Of copcphotography@xxxxxxxxxxxxxxxxx Sent: Friday, May 17, 2013 12:46 PM To: optimal@xxxxxxxxxxxxx Subject: [optimal] fluorescein reactions? just an unscientific survey please which has less reactions? 10% or 25% fluorescein? I'm guessing that I have about one patient everyother year will have more than just nausea. And its been about four years since I've called an ambulance for a reaction. And only a few per year that will be more than just nauseated, but full out vomiting. (those aren't fun) Just curious. Lori Lori Guerette, CRA COA Consulting Ophthalmologists, PC 704 Hebron Ave, Ste 200 Glastonbury , CT 06030 860-678-0202 860-304-4703 copcphotography@xxxxxxxxxxxxxxxxx justhitanykey@xxxxxxxxxxx