Keywords: Preoperative Care; Anaesthesia; Ophthalmologic Surgical Procedures;
J Comm Eye Health 2003;16(48): 63
LETTERS TO THE EDITOR
Povidone-iodine
Dear Editor,
With reference to the report by Sherwin J Isenberg and Leonard Apt in J Comm Eye Health Vol. 16, No. 46, 2003: I would like to add that povidone-iodine 5% solution can only be used pre-operatively after a local anaesthetic has been given as otherwise it is too painful.
I would like to ask for clarification on the strength of the eye drops for prophylaxis of ophthalmia neonatorum. The WHO/PBL manual Local Small Scale Preparation of Eye Drops, (Eye Drops Update 2002), advises a 1% solution of povidone-iodine and not 2.5%.
The same manual suggests povidone-iodine 1% for routine treatment of conjunctivitis and not 1.25%. The problem with the stronger concentrations is that they are painful to use and, therefore, compliance will tend to be less, certainly in children.
Editor’s Note : We have asked Alistair Bolt, Consultant for the WHO/PBL manual, Eye Drops Update 2002, to respond to this concern.
Dr Hogeweg is correct to say that 5% povidone-iodine drops are only suitable for use after a local anaesthetic, as instillation causes stinging and an acute red eye.
Concentrations of povidone-iodine of 1% to 1.25% cause transient stinging, and a 2.5% drop is definitely uncomfortable. If used for bacterial conjunctivitis, compliance with the 2.5% drop would be low, the 1% strength would be tolerable. However, there has not been any published research on using 1% povidone-iodine for the prophylaxis of ophthalmia neonatorum.
The 5% drop in the WHO Manual Eye Drops Update 2002 is only for prophylaxis prior to surgery, the 1% drop is included as a broad spectrum antibacterial.
