Before intravitreal injections, which antiseptic is commonly used on the eye?

Before intravitreal injections, which antiseptic is commonly used on the eye?

• A. Povidone-iodine
• B. Chlorhexidine
• C. Hydrogen peroxide
• D. Isopropyl alcohol

Answer: (A)

Povidone-iodine is used because it provides rapid, broad-spectrum antimicrobial activity on the ocular surface with minimal toxicity at the appropriate concentration. In practice, a 5% povidone-iodine solution is applied to the conjunctival sac and surrounding eyelids before intravitreal injections and left in place for about 30–60 seconds to maximize kill of surface bacteria, which substantially lowers the risk of endophthalmitis. Chlorhexidine is effective in many settings but is not as consistently proven or tolerated on the ocular surface for intravitreal antisepsis; it can be irritating to the cornea in higher concentrations. Hydrogen peroxide can cause corneal toxicity and bubbles that complicate the procedure, and isopropyl alcohol is too irritating and unsafe for the eye.

Povidone-iodine is used because it provides rapid, broad-spectrum antimicrobial activity on the ocular surface with minimal toxicity at the appropriate concentration. In practice, a 5% povidone-iodine solution is applied to the conjunctival sac and surrounding eyelids before intravitreal injections and left in place for about 30–60 seconds to maximize kill of surface bacteria, which substantially lowers the risk of endophthalmitis.

Chlorhexidine is effective in many settings but is not as consistently proven or tolerated on the ocular surface for intravitreal antisepsis; it can be irritating to the cornea in higher concentrations. Hydrogen peroxide can cause corneal toxicity and bubbles that complicate the procedure, and isopropyl alcohol is too irritating and unsafe for the eye.