Povidone-iodine eye drops work against adenoviral conjunctivitis

A single, in-office administration of 5% povidone-iodine (PVP-I) proves useful in the treatment of patients with adenoviral conjunctivitis, reducing viral load and rapidly improving clinical signs and symptoms, according to the results of a pilot trial.

Fifty-six adult patients presenting with adenoviral conjunctivitis (symptoms ≤4 days and a positive AdenoPlus test) participated in the trial. None of them had thyroid disease, iodine allergy, recent ocular surgery, and ocular findings inconsistent with early-stage adenoviral conjunctivitis.

The patients were randomized to receive a single treatment with 5% PVP-I or artificial tears (control) in one eye.  They underwent examinations on days 1–2, 4, 7, 14, and 21 thereafter, with conjunctival swabs collected each visit for quantitative polymerase chain reaction.

At baseline, 28 out of the 56 patients had detectable viral titres. Viral titres were much lower in the PVP-I than in the control group at day 4 post-treatment (2.5 percent vs 14.4 percent of peak, respectively; p=0.020).

Likewise, day-4 results for other outcomes including severity of participant-reported tearing, lid swelling, and redness, as well as clinician-graded mucoid discharge, bulbar redness, and bulbar oedema, were more favourable in patients who received 5% PVP-I (p<0.05).

After the fourth day, both groups showed further reductions in viral titres, severity of signs, and symptoms, with no significant differences.