Recent reports suggest that povidone-iodine (Betadine solution), a frequently used preoperative antiseptic for eye surgery, is also a good treatment for such external ocular infections as adenoviral conjunctivitis. But how should you apply it?

Robert Abel, Jr., M.D., and Ari D. Abel, M.D., recommend either swabbing with 10% solution on all four lids and leaving the eye for 30 to 60 seconds before irrigation, or using a 5% ophthalmic solution t.i.d. for several days until symptoms improve. Swabbing is preferable for patients who may have a compliance problem or difficulty obtaining the solution. Topical treatment with drops allows the patient to titrate his dose. Warn the patient about rubbing his eyes and about personal hygiene to avoid spreading the infection.

Thirty-four of 36 adenoviral conjunctivitis patients Dr. Abel studied found improvement in their condition within 34 to 48 hours, using no other treatment but povidone-iodine.

Dr. Abel says that povidone-iodine is safe and effective to use both for prophylaxis and treatment of many bacteria, chlamydia and viruses. Furthermore, because of concentration levels, swabbing of the lids is thought to treat the affected tissue more directly than simple instillation of drops.