Povidone-iodine
Anti-infective · Rx
Trade namesBetadine 5% Sterile Ophthalmic Prep Solution
Drug classAntiseptic (peri-procedural / adjunct)
Strength5% (prep); dilute 1-2.5% for surface use
AvailabilityRx
Mechanism of actionFree iodine is rapidly microbicidal against bacteria, viruses, fungi and amoebae with negligible resistance. Standard antisepsis before any intraocular procedure.
Indication / reason for useAntisepsis before cataract/intravitreal/other intraocular surgery; adjunct in adenoviral (epidemic) keratoconjunctivitis and as neonatal ophthalmia prophylaxis (2.5%) in some protocols; irrigation for bacterial/viral conjunctivitis in resource-limited settings.
Usual adult dosingSurgical prep: 5% into the fornix for ≥3 min before surgery. Surface antiviral use: dilute (1.25-2.5%), single or short in-office application with copious irrigation afterward.
PreservativePreservative-free (the iodine is the biocide) , a preservative-free option exists
Contact lensesRemove lenses before use.
Common / important adverse effectsStinging/burning, punctate keratopathy, transient corneal edema, allergic contact dermatitis; true iodine allergy is rare (shellfish allergy is not a contraindication).
Contraindications & cautionsDocumented iodine hypersensitivity; thyroid disease is a relative caution with repeated large exposures; neonates (thyroid), use lowest effective concentration.
Pregnancy / lactationSingle peri-procedural use is standard; avoid repeated large mucosal exposure (fetal thyroid).
Practice notesThe single most important step for endophthalmitis prevention. Not for take-home use.
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.