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Why we use povidone iodine (PI) before eye procedures
One of the most serious complications after any intraocular procedure is an infection inside the eyeball. (Intraocular means 'within the eyeball').
The risk of intraocular infection with modern day techniques varies between procedures, but it is generally below 1 in 1000.
One of the most effective measures to reduce the risk of infection is the use of povidone iodine (PI) as an antiseptic before your procedure. We use it on the surface of your eye and on the skin surrounding it.
Does a reaction to PI mean I am allergic?
PI can cause eye irritation or contact dermatitis in some patients and this is frequently mistaken for an allergy. True allergy to povidone iodine is extremely rare.
When you attend the eye clinic, tell your doctor or nurse if you have been previously diagnosed with an allergy to PI.
Is allergy to seafood or radiocontrast related to PI allergy?
No. There is no evidence of increased risk of allergy to PI if you have an allergy to other iodine-containing product such as seafood or radiologic contrast.
Other considerations
Patients who have been diagnosed with problems on the surface of the eye (for example dry eyes), or who use glaucoma drops, may experience more symptoms than others.
Can I do anything to reduce iodine sensitivity before my procedure?
It is not unusual to have some reaction (sensitivity) to iodine.
We make every effort to reduce possible irritation by thoroughly washing out the iodine.
The use of ocular (eye) lubricants before and after your intraocular procedure can help you to manage the symptoms.
Can you use alternative antiseptic agents, instead of PI?
There is no other antiseptic agent licensed in the UK for use on the surface of the eye.
For patients allergic or highly sensitive to PI we can use another antiseptic agent called chlorhexidine gluconate, which is unlicensed. Chlorhexidine is a good alternative antiseptic agent, but it is not considered as effective at reducing the risk of intraocular infections as PI.
To prevent the risk of serious infection, our advice and policy is to use PI as first line antiseptic agent, rather than chlorhexidine.
Contact information
Royal Eye Unit
Kingston Hospital
Galsworthy Road
Kingston upon Thames KT2 7QB