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Introduction ⬇

Fluorescein angiography (FA), also known as fluorescent angiography, is a procedure performed to detect vascular disorders of the retina that may be the cause of poor vision. Fluorescein, a yellow-red contrast substance, is injected intravenously over a 10- to 15-second period. Under ideal conditions, retinal capillaries 5-10 μm in diameter can be visualized using FA. Images of the eye, taken by a special camera, are studied to detect the presence of retinal disorders. Choroidal circulation is not seen with color photographs.

Procedure ⬆ ⬇

  1. Administer a series of three drops to dilate the pupil of the eye. Complete dilation occurs within 30 minutes of giving the last drop.

  2. Obtain a series of color photographs of both eyes once dilation is complete.

  3. Have the patient sit with the head immobilized in a special headrest in front of a fundus camera.

  4. Inject fluorescein dye intravenously.

  5. Obtain a series of photographs as the dye flows through the retinal blood vessels over a period of 3-4 minutes.

  6. Obtain a final series of photographs 8-10 minutes after the injection.

Procedural Alert

  1. Some patients may experience nausea for a short period of time following the injection.

  2. The eye drops may sting or cause a burning sensation.

Clinical Implications ⬆ ⬇

Abnormal results may reveal:

  1. Diabetic retinopathy

  2. Aneurysm

  3. Macular degeneration

  4. Diabetic neovascularization

  5. Blocked blood vessels

  6. Leakage of fluid from vessels

Interventions ⬆ ⬇

Pretest Patient Care

  1. Determine whether the patient has any known allergies to medications or contrast agent.

  2. Instruct the patient about the purpose, procedure, and side effects of the test.

  3. Insert a peripheral IV catheter.

  4. Follow guidelines in Chapter 1 for safe, effective, informed pretest care.

Posttest Patient Care

  1. Inform the patient that they may experience color changes in the skin (yellowish) and urine (bright yellow or green) for 36-48 hours after the test.

  2. Advise the patient to wear dark glasses and not to drive while the pupils remain dilated (4-8 hours). During this time, patients are unable to focus on nearby objects and react abnormally to changes in light intensity.

  3. Review test results; report and record findings. Modify the nursing care plan as needed.

  4. Follow guidelines in Chapter 1 for safe, effective, informed posttest care.

Reference Values ⬆

Normal