Ride it out like a bad storm
But even with the topical NSAID and preservative-free artificial tears onboard (plus an “occasional” drop of prednisolone acetate 1% that I keep around for “special occasions”) the stinging was noticeable for a day or two afterward. I had even dryer-than-usual eye for a few weeks after that. Everything has consequences. Betadine lavage may work and might be a good option for someone who has symptomatic SEIs or can’t afford to lay low until they’re no longer contagious. But I found the weeks-long extra dry eye to be a significant trade-off.
Since then, I’ve had several occasions to consider using Betadine lavage on my patients, and I’ve always explained to them that it’s an off-label use with its own side effects. I make sure they know that we lack well-designed clinical trials and that the evidence for its efficacy is anecdotal.
More from Dr. Brown: Experiencing retinal detachment as an OD
If they’ve managed to stay with me through all that, I then tell them my own little anecdote. It seems that it’s my lot in life to experience every ocular malady known to man and then tell scary stories about them.
That’s the moment when they really perk up and listen. Some patients proceed with the treatment. Others decide to just take their chances and ride it out like they would a bad storm.