Document gavrr1rXqwBKZQmmda5JeGpYe
AHAZG _ 06/
PFOA
Acute Toxicity - J
000847
HAZLETON
LABORATOIRES AMERCA.MC. 3301 KINSMAN BLVD.. P.O. BOX 7545 MADISON. Wl 53707 USA
FINAL REPORT
Karen Armstrong 3M Toxicology Services Building 220-2E-02 St. Paul, MN 55144-1000
Sample: T-4416
HLA Number: 91201741
Enclosed: Primary Eye Irritation/Corrosion Study in Rabbits (OECD Guidelines)
o Key Personnel o Methodology o Summary of Results o References o Raw Data Appendix
Signed: Study Director Acute Toxicology
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
-- e?, -to Date
" ~ ~ TM o ( T T r 5 r s
0 HAZLETON LABORATORES AMEF6CA.MC. 3301 KINSMAN BLVD.. P.0. BOX 754S MADISON. Wl S3707 USA HLA Number: 91201741
Sample: T-4416
Acute Toxicology Steven M. Glaza Study Director Section Supervisor Steven R. Sorenson Study Coordinator Patricia Padgham Group Leader Sharen L. Howery Report Coordinator
Page 2
KEY PERSONNEL
Quality A?SMHtn<? Deborah L. Keller Manager
Laboratory Animal Veterinarian Cindy J. Cary, DVM Diplomate, ACLAM
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
* CORNINO LUxntory Samte Company
000849
HAZLETON
l a b o r a t o r ie s a m e r c a . i \ ic . 3301 KINSMAN BLVD., P.O. BOX 7545 MADISON, Wl 53707 USA
HLA Number: 91201741
Sample: T-4416
Page 3
METHODOLOGY
Objective: To assess the relative level of ocular irritation/corrosion produced following a single exposure of a test substance to one eye of albino rabbits according to the Organisation for Economic Cooperation and Development's Guidelines for Testing Chemicals.1
Test Material: T-4416 Physical Description: Purity and Stability:
Storage and Retention:
Safety Precautions:
Clear colorless liquid Sponsor assumes responsibility for purity and
stability determinations (including under test conditions). The test material was stored at room temperature. Any unused material will be returned to Sponsor according to HLA Standard Operating Procedure. Normal handling procedures were used according to HLA Standard Operating Procedure.
Test Animal: Adult albino rabbits, Hra:(NZW)SPF, were procured, maintained individually in screen-bottom cages in temperature- and humidity-controlled quarters, provided access to water ad libitum and a measured amount of High Fiber Rabbit Chow 5326, Purina Mills, Inc., and held for an acclimation period of at least 7 days. Animal husbandry and housing at HLA comply with standards outlined in the "Guide for the Care and Use of Laboratory Animals".2 If variations from the prescribed environmental conditions existed, they were documented and considered to have no effect on the study outcome. No contaminants were expected to have been present in the feed or water which would have interfered with or affected the results of the study.
One male and two female acclimated animals, weighing from 2148 to 2500 g,
were chosen at random for the test. The animals' eyes were examined within 24 hours prior to test material administration using sodium fluorescein dye
procedures. Only those animals with no sign of ocular injury or irritation
were used. Test animals were identified by animal number and corresponding ear tag.
Reason for Species Selection: Historically, the New Zealand White albino
rabbit is the animal of choice based upon its large orbit and nonpigmented iris.
Preparation and Administration of Test Material: The sample was dosed as received. The pH was determined to be 9.9.
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
000850
0 HAZLETON LABORATORES AVtERCA. rs)C. 3301 KINSMAN BLVD., P.O. BOX 7545 MADISON, Wl 53707 USA
HLA Number: 91201741
Sample: T-4416
Page 4
Treatment: Each rabbit received 0.1 mL of the test material placed into the everted lower lid of one eye, with the contralateral eye serving as the untreated control. The upper and lower lids were gently held together for 1 second to prevent loss of material and then released. The eyes of the rabbits remained unflushed.
Reason for Route of Administration: Historically, the ocular route is the route of choice based on the method of Draize.
Observations: The treated eyes were observed for ocular irritation at 1, 24, 48, 72 and 96 hours, and Days 7, 14 and 21 after treatment.
At the 24- and 72-hour, and 7-, 14- and 21-day readings, sodium fluorescein was used to aid in revealing possible corneal injury. Irritation was graded and scored according to the Draize technique.
Animals were weighed just prior to test material administration and at weekly intervals throughout the study.
Termination: At termination of the experimental phase, all animals were euthanatized and discarded.
Statistical Methods: No statistical method was performed.
Location of Raw Data and Final Report: The raw data and a copy of the final report will be retained in the archives of HLA.
PHONE (60S) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
OOn^m tO LAtKWMovy Sorvic-- Company
000851
HAZLETON
l a b o r a t o r e s a m e s c a . rsic. 3301 KINSMAN BLVD., P.O. BOX 7545 MADISON. Wl 53707 USA
HLA Number: 91201741
Sample: T-4416
Page 5
SUMMARY OF RESULTS
Test Animal: Albino Rabbits - Hra:(NZW)SPF Source: Hazleton Research Products, Inc., Denver PA Date Animals Received: 12/19/89
Start Date (In-life): 01/10/90
End Date (In-Life): 01/31/90
Average Primary Eye Irritation Scores*
Observation Period
Average Score
1 Hour 24 Hour 48 Hour 72 Hour 96 Hour Day 7 Day 14
Day 21
41.0 49.0 36.0 38.3 34.3 16.0
6.0
0.0
* The average primary eye irritation score is the total eye irritation
score for all the animals divided by the number of animals (3) at each observation period.
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
O O RNM O U fto m o y Sarvien Company
000852
HAZLETON
UABORATORCS AM ERCA.NC 3301 KINSMAN BLVD.. P.O. BOX 7545 MADISON. Wl 53707 USA
HLA Number: 91201741
Sample: T-4416
Page 6
Animal Number F31165
F31127
Observation Period
1 Hour 24 Hour 48 Hour 72 Hour 96 Hour Day 7 Day 14 Day 21
1 Hour 24 Hour 48 Hour 72 Hour 96 Hour Day 7 Day 14 Day 21
Table 1 Individual Eye Irritation Scores
Cornea AB
14 14 13 14 13 21 00 00
Score AXBX5
20 20 15 20 15 10
0 0
Iris A
1 1 1 1 1 0 0 0
Score AX5
5 5 5 5 5 0 0 0
14 14 14 14 14 11
11
00
20 20 20 20
20 5 5 0
1 1 1 1 1 1 1 0
5 5 5 5 5 5 5 0
Coniunctivae
AB
23 33 32
32 32 21 10 00
3 3
2 2 1 0 0 0
23 33 32 32 32 21 21 00
3 3 1 2 2 0 0 0
Score fA+B+C12
16 18 14 14 12 6 2 0
16 18 12 14 14
6 6 0
F31194
1 Hour 24 Hour 48 Hour 72 Hour 96 Hour Day 7 Day 14 Day 21
14 24 14 14
13 12 00
00
20 40 20 20 15 10
0 0
1 1 1 1 1 0 0 0
5
23
3
16
5
33
2
16
5
32
1
12
5
32
1
12
5
32
1
12
0
21
0
6
0
00
0
0
0
00
0
0
Cornea A - Degree of opacity B - Area of involvement
Conjunctivae A - Redness B - Chemosis
C - Discharge
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
OOMmiwO LUwmoy Stm cm Cempm*
000853
H A Z L E T Q [\
LABORATORIES AMERCA.IMC. 3301 KINSMAN BLVD., P.O. BOX 7545 MADISON, Wl 53707 USA
HLA Number: 91201741
Sample: T-4416
Page 7
Table 2 Sodium Fluorescein Examination
Animal _______________________ Observation Period
Number Pre-initiation 24 Hour
72 Hour
Dav 7
Dav 14 D a y _ H
F31165 F31127 F31194
NEG NEG NEG
POS (80%) POS (55%) POS (15%)
NEG
POS (100%) POS (80%) POS (5%) POS (5%)
POS (75%) POS (80%)
NEG
NEG
NEG NEG NEG
NEG - No stain retention POS - Positive stain retention (area of cornea involved)
Comments:
A pain response (excessive pawing of the treated eye) was elicited in all three animals following instillation of the test material.
Blanching of the conjunctivae was observed in all three animals at 1, 24, 48, 72 and 96 hours, and Day 7.
Petite hemorrhaging of the conjunctivae was observed in two animals at 24 hours.
Corneal epithelial peeling was seen in all three animals at 24, 48, 72 and 96 hours, in two animals at Day 7, and in one animal at Day 14.
REFERENCES
1. "Acute Eye Irritation/Corrosion," Organisation for Economic Cooperation and Development's Guidelines for Testing of Chemicals, Section 405 (adopted May 12, 1981).
2. NIH Publication No. 86-23 (revised 1985).
3. Draize, J. H., "Eye Mucosa," In: Appraisal of the Safety of Chemicals in Foods, Drugs and Cosmetics - Dermal Toxicity, Association of Food and Drug Officials of the U.S., pp. 49-50 (1975).
PHONE (608) 241-4471 FACSIMILE (608) 241-7227 TELEX TLX 703956 HAZRAL MDS UD
a o o m n m q I hornno Swviom pw yany
000854
I
LA-. . g i a c i m i
PERSONNEL SIGNATURE SHEET ACUTE TOXICOLOGY
Name
Job Title
Signature
Initials
Becky Beckwith Ann Bursaw Anthony Cass Cindy J. Cary, DVH Kari Gassen
Lab Animal Technician Sr. Clerk
h
J3& _
Lab Animal Assistant Lab Animal Veterinarian Sr. Lab Animal Assistant
n k \\lyTYU-l CcXiljL |0 yCoAtv
K o h , A M rkA A a rx _
<xa
%
Steven H. Glaza
Section Supervisor
_______
Ben Haley
Sr. Lab Animal Assistant
Jeff Hicks Sharen L. liowery
Lab Animal Technician Research Assistant
sP:Lfj'jUVj
Jim Jirschele Wayne Madison Bud McDonald Eileen McConnell Henry Mikula Albert Oleson
Lab Animal Assistant
L~ PutJilz/ ^
Senior Section Supervisor C(h 'p >*f 0 .
Sr. Lab Animal Assistant $ i< A /V c fty \a J c /
Administrative Clerk
Lab Animal Assistant
fin ite.00 ^ o ':C r
Sr. Lab Animal Assistant
JjL f^.vt-i
/ j >7<cS\
.^ AO
Patricia Padgham
7V>
Jane Pol now
cypL
Steven R-. Sorenson
Dawn Thieding
/
Annette R. Turner
4io
(09/11/89)
--
000855
EC3 UZlur.T/UUSE HE LORD
hla: q i a n n m
S:'j;!y title: Primary Eve Irritation Test materia :: T-TUIto
Aiiys i c al d e s c r i p t i o n : r t t f t n
c v taitbu.tia
cH result: q.S with CORUI.'IG pH MEIER 110.05510
t ; s e : Q , \ m uA o ( n i e o u i v a l e n t )
_cosec w i:n a i-wL d i s p o s a b l e s y r i n g e / ^ t \ each cose
" i n s I v idduuaa l l y d r a wn up w i t h a
- in.L hn a i . - ..ini ct o n Sa y r i n g e
D a t e a n i m a l s r e c e i v e d : ________ i ? / i q | y i ________
Spec i s s / s t ra i r. : Rabbi s/ wew ea tane n u e
S our ce: Hat 1eton Research Rrcouc: : , Inc.
Room t l o :
M In t
Review o f fo ld e r preparation by:
Jff.!
Hate:
In itia l
An ir.:J 1 tlo. Green Sex cr #
F3 H U S nan
i r ? H ec-. ,9
ii . 9
Pain Response Following
D o : ino
c
F
Animal body W eights (g)
In i t i Jt icn Uav 7 Dav 14 Uav 21
SCO 2238
<&
2 J c L _ 2&19 Z .E S &
I'J'lb 1
d 2.L o ? ^
F
2 lM 73 3* 1
z s t< 4
11
A ll anim als appeared normal
j u s t prior t o des i n o .
Technician:
bate:
' / ip fO o
* - Sodium f lu o r e s c e in exammat ior..
HEG - n e g a t i v e .
AOS - P o s i t i v e . IIA - H o t app I i c a p l e .
U - U n a b l e t o d e t e r m i n e pM.
V - Voca I ia a t ten. Z - E x c e s s ive pawing of treated eye.
II - H o ne
Mft Dozed d i r e c t l y cn t h e c o r n e a .
The e y e lid s were released
irr-.e d 1 a t e 1v w i t h o u t f o r c e d b lin kin g cr m anipulaticn.
Techn ic ian
<
Date 1990
/J
leale Used KTP.OII
u
/& ltd
e `L
HOOZ1
1
10 *
1 `/ n
1 L^ 1'
<s `/ m
------
'/a/_
Dosed in the c o n ju n c tiv a l sac. The u p p e r and low er 1 ids were g e n t l y h e l d t o g e t h e r l o r une secund.
Time o f d o s in g :
lo .5 o c > ro
T e c . m l c 1 a n _ ____J> .. _ u a t e : `Im M D
<to02L! 1
_ U a t e : _ J A l3 f2 .
a u r v i v i n g animals d e s i g n a t e d f o r s a c r i f i c e and d i s c a r d . T e c h n i c i a n ____Date / - ty . c ^
000856
Reviewed by:
{ C0c51/ viat)
------------------------------ ^
Date: 2 ^ - f S - ^ C a
Approximately 5 minutes prior to test
nateTfai^diainistration _______ drops
of proparacr?n?''fh-5cif _____ _________
Lot ___________ ) v/s^^nrs^jj 1ea into
__ eyels) of each rabbit.
Technician
Date
LA: qiaonMl
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:______j________________
Test material:_~ T- IU_______________________________________ Test eve: Right
Washed:
seconds following instillation of test material, the test eye was washed wi th mL of lukewarm tap water forn& seconds.
u*-tlnwashed
Animal No. Location of corneal lesions
Tall ---- Head
Observation Period: __ 1
m C\) ( )3 n u s
nan
\
O
Cornea - Opacity
ii
)
Iris
Area
v i1 i1
Conjunctivae Redness
3 2
i
Chemos1s
3 33
D1 scharqe Sodium fluorescein exam
Technician:____
77S
Date:___________ 'Jihi
iC ^ ___
3C 0 ^
EYE IRRITATION SCORE: airs________________
Calculated By:
Date i - i u - ^ r i
Verified Bv: ... J t Date'
NA Not applicable. A - Petite hemorrhaging. B - Blanching.
C - Clear discharge. D - Purulent discharge.
E - Hair loss around the eye. F - Necrotic areas.
G - Unable to visualize due to severe swelling.
H - No reaction to light. I - Injected.
J - Corneal epithelial damage, K - Corneal epithelial damage,
L - Corneal epithelial damage, M - Hypopyon. N - Corneal neovascularization. P - Pannus. R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:
Date: iS r S O
000857
HLA:. q i a o n M l
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:_____ j________________
Test material: T- M4 ii*____________________________________ _ Test eve: Right
m Pi Mashed: j r seconds following Instillation of test material, the test eye was washed wi th oA mL of lukewarm
tap water (or>m seconds.
i^^Unwashed
Animal No. Location of corneal lesions
Tall ---- Head
Cornea - Opacity
3
$ 1
f 1
Iris
Area
*4
\*
Conjunctivae Redness
Chemos1s
3.A&
A
D1 scharqe
*>C
PtKO&l*Sodium fluorescein exam
\nt*4
CS)0
z.
3I* A
2J-
0
Technician: Date :
l~t i-lO
EYE IRRITATION SC0RE:^ U c . a q . O _________
Calculated By:
Date
Verified By:_____ 4 # Date
NA -- Not applicable. A - Petite hemorrhaging.
B - Blanching. C - Clear discharge. D - Purulent discharge.
E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light. I - Injected.
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling.
L - Corneal epithelial damage, pitting. M - Hypopyon. N - Corneal neovascularization.
P - Pannus. R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
d>A)TJiy
Hr
<2)CAULU<_ATKm J GRAGA. tc=t /-/-So
Reviewed by:_
Date:
OOOS^P
LA: q i a o n M l
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:______[______________________ Test material: T- il._______________________ _______________ Test eve: Right__
Washed: (j r seconds following Instillation of test material, the test eye was washed wl th pts mL of lukewarm tap water lora seconds.
^ -Unwashed
Technician:_______ ^~7-/
Date:___________ S-/J-Y
NA -- Not applicable. A - Petite hemorrhaging. B - Blanching. C - Clear discharge. D - Purulent discharge. E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light. I - Injec ted.
EYE IRRITATION SCORE:
r-,______________
Calculated By:_____ g-* Date /-/u-Qa
Verified By:
/jA Pate hvQn
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling.
L - Corneal epithelial damage, pitting. M - Hypopyon. N - Corneal neovascularization.
P - Pannus. R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:
Date:
000859
HLA: q i a o n M l
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:______!______________________
Test material: T~ M ^ i u ............................... ..... ... Test eve: Right
>iPt Washed: o r seconds following Instillation of test material, the test eye was washed wi th m , ml of lukewarm
^ Unwashed
tap water torm seconds.
Animal No. Location of
corneal lesions
3
Ta11 ---- Head
I1U5 J-- ceZ
\
j - /v n
oo
Cornea - Opacity
! !/
Area
i1/
Iris
/r
Conjunctivae Redness
Chemos1s
J-
D1scharqe
3 c.
Sodium fluorescein exam Pc>s
/ r / y'
. r7^ J /c
Zbsw Z
\\ \ \
Technician:. Date:______
EYE IRRITATION SCORE:
^
Calculated By:_____ Date /d. i b 3 d _ Verified By:______ /-f Date
NA - Not applicable. A - Petite hemorrhaging.
B - Blanching.
C - Clear discharge. D - Purulent discharge.
E - Hair loss around the eye.
F - Necrotic areas. G - Unable to visualize due to
severe swe1 1 1 ng. H - No reaction to light. I - Injected.
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling.
L - Corneal epithelial damage, pitting. M - Hypopyon. N - Corneal neovascularization.
P - Pannus. R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:
Date: 2 .- - O n
000860
HLA: qiaonMI
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group :______j________________
Test material : T- il.________________________________________ Test eve: Right
Washed: >j r seconds following Instillation of test material, the test eye was washed with nts ml of lukewarm
tap water fornc\ seconds.
t ^ fclnwashed
Technician:
Date:_______ ! - ! < - / - < ^ 0
NA - Not applicable. A - Petite hemorrhaging. B - Blanching. C - Clear discharge. D - Purulent discharge. E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light. I - Injected.
EYE IRRITATION SCORE:
^ ______________
Calculated By:_____ Date /-/y
Verified By:
sfR Date `/zil4n
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling. L - Corneal epithelial damage, pitting. H - Hypopyon. N - Corneal neovascularization. P - Pannus. R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
<D>orrR:^ ficcrtts
Reviewed by:_____ S > Date:
000861
HLA:_ q i a o r n u
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:______j________________
Test material: T - M<4 il.________________________________________ Test eve: Right
ifH Washed: jft seconds following Instillation of test material, the test eye was washed with m <\ ml of lukewarm
tap water for><& seconds.
__tJnwashed
_________________________________01nervatlo 1 Period: ~1 fwi
Animal No. Location of
corneal lesions
3
\ oo
Tall ---- Head
\
Cornea - Opacity
)
Iris
Area
11
2,
1 X-
O
Conjunctivae Redness
ln
Chemosis
D1 scharqe
o
Sodium fluorescein exam ( o A
Ie 1
O ?*<>
i 1
o
N*->
Technician:__________ Date:_____________
EYE IRRITATION SCORE:
Calculated By: Verified By:______A
__________
Date Date `/iJqo
NA -- Not applicable. A - Petite hemorrhaging.
B - Blanching.
C - Clear discharge. D - Purulent discharge.
E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light. I - Injected.
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling.
L - Corneal epithelial damage, pitting. M - Hypopyon. N - Corneal neovascularization. P - Pannus.
R - Unable to visualize due to
severe opacity. S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:
Date;
000862
.HLA:_ q i a o n M l
PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:______|______________________ Test material: T- M M i u ________________________________________ Test eve: Right
Washed: seconds following Instillation of test material,
the test eye was washed wl th Mts mL of lukewarm
tap water torn(x seconds.
Animal No. Location of
corneal lesions
3
C) ( ') OTall ---- Head
nus
\(X)O
__Unwashed
C)
Cornea - Opacity Area
n [o 0 iD
Iris
Conjunctivae Redness
Chemosis
oO
1 2- O o IO
0 1 scharqe Sodium fluorescein exam
0
r> sy*
P-i,
O Otc>
Technician : Date :_____
A--
./ A w
NA -- Not applicable. A - Petite hemorrhaging. B - Blanching. C - Clear discharge. D - Purulent discharge. E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light.
I - Injected.
EYE IRRITATION SCORE: (. r>_________
Calculated By: / < Date 7?M^rT
Verified By:
^ Date i - M - q p
J - Corneal epithelial damage, peeling. K - Corneal epithelial damage, piling.
L - Corneal epithelial damage, pitting. M - Hypopyon. N - Corneal neovascularization.
P - Pannus.
R - Unable to visualize due to severe opacity.
S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:_
Date :
000863
HLA:. q i a o n M i PRIMARY EYE IRRITATION TEST OBSERVATIONS
Group:_____ [______________________
Test material : T- M4 i l . ________________________________________________________ Test eye: Right
Mashed: ijtx seconds following Instillation of test material, the test eye was washed wl th jfr ml of lukewarm
tap water forncx seconds.
^-Unwashed
Animal No. Location of corneal lesions
Tall .... Head
\Observation Period:
11U S ,,
9 \ kftb
C) 0 Cs)O
C)
Cornea - Opacity Area
Iris
oo
oo oo
o o o
Conjunctivae Redness
Chemosis
oo no
o Q
0 1 scharqe
0o
O
Sodium fluorescein exam
Technician:
_________
Date:________/ - .^1- Q O
EYE IRRITATION SCORE:. -Q :-Q .
Calculated By:__
Datei-.-\i -<=>o
Verified By:____
Date ~ > - r - 9 0
NA -- Not applicable. A - Petite hemorrhaging.
B - Blanching.
C - Clear discharge. D - Purulent discharge. E - Hair loss around the eye. F - Necrotic areas. G - Unable to visualize due to
severe swelling. H - No reaction to light. I - Injected.
J - Corneal epithelial damage, peeling, K - Corneal epithelial damage, piling,
L - Corneal epithelial damage, pitting. M - Hypopyon.
N - Corneal neovascularization. P - Pannus.
R - Unable to visualize due to severe opacity.
S - Granulation scar tissue. POS - Positive stain retention. NEG - Negative stain retention.
Reviewed by:
.I s
Bate: 7. - ^ - ^
000864