Povidone-Iodine 5% Ophthalmic Solution

How it works

It releases free iodine that oxidises microbial proteins, nucleotides and lipids, producing rapid, broad-spectrum killing of bacteria, viruses and fungi on the ocular surface.

Prescribing in practice

• It is an antiseptic for surgical/procedural skin and conjunctival preparation, not a treatment drop, and the higher concentrations used for periocular skin must not be introduced into the eye in the same strength.
• Avoid in patients with known iodine hypersensitivity and use caution with thyroid disorders given systemic iodine absorption with repeated exposure.
• Adequate contact time on the ocular surface is needed for antisepsis, after which residual solution is irrigated as per local protocol.

Monitoring

No routine monitoring is required for single peri-procedural use; observe for surface irritation or hypersensitivity reactions.

Counselling the patient

• This is a cleaning antiseptic used to make the eye sterile before your procedure, not a medicine to take home.
• Tell the team if you have ever reacted to iodine or iodine-containing antiseptics.
• Some transient stinging or surface dryness afterwards is expected and settles.

Evidence & guidelines

Pre-operative povidone-iodine antisepsis is the established standard for reducing endophthalmitis risk before intraocular surgery and intravitreal injection, endorsed by ophthalmology surgical guidance.