Rose bengal
Dilation & diagnostic · Rx
Trade namesRosettes strips, 1% solution
Drug classDiagnostic dye, vital stain
StrengthStrips (1.3 mg); 1% solution
AvailabilityRx
Mechanism of actionStains cells lacking a protective mucin/glycocalyx layer and devitalized epithelium; also has antiviral staining characteristics useful in herpetic disease.
Indication / reason for useDry eye (interpalpebral staining), herpes simplex dendrites (stains the swollen epithelial cells at the ulcer margin), ocular surface squamous neoplasia mapping.
Usual adult dosingWet the strip and apply to the inferior fornix; assess under white light.
PreservativePreservative-free strips , a preservative-free option exists
Contact lensesRemove soft lenses before use.
Common / important adverse effectsSignificant stinging and irritation, especially in dry eyes (limits its use); transient pink staining of the lids. Topical anesthetic beforehand reduces discomfort but can itself cause staining.
Contraindications & cautionsNone absolute; largely replaced by lissamine green because of the discomfort.
Pregnancy / lactationLow risk for diagnostic use.
Practice notesReach for lissamine green first; rose bengal remains useful for demonstrating HSV epithelial disease.
Chair-side reference only. Dosing, contraindications and pregnancy guidance here are not exhaustive. Confirm against the current prescribing information and the patient’s full history before prescribing or advising.