• Lissamine green staining of the conjunctiva, a new and widely heralded aid for diagnosing early xerophthalmia, was found to be a reasonably specific but inadequately sensitive test for practical use. While 82% of clinically normal children failed to show staining, so did 57% with night blindness, 29% with vitamin A responsive Bitot's spots, and, most significantly, 26% with severe, vitamin A related corneal involvement. The test also failed to distinguish vitamin A responsive "Bitot's spots" from nonresponsive ones.
Nani Emran, Alfred Sommer. Lissamine Green Staining in the Clinical Diagnosis of Xerophthalmia. Arch Ophthalmol. 1979;97(12):2333–2335. doi:10.1001/archopht.1979.01020020549009