topical beta-blockers in open angle glaucoma

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The principal beta-blockers used in glaucoma include timolol and carteolol - both non-specific - and betaxolol, which is a beta-1-receptor antagonist.

These agents are used to lower the intra-ocular pressure by reducing aqueous inflow. Their effects last up to 24 hours enabling twice daily regimes.

It has been shown that timolol lowers intraocular pressure (IOP) by 25-27% with an onset over 2 hours (other nonselective beta-blockers have a similar efficacy) .

Ocular side effects infrequent but include corneal anaesthesia with punctate epithelial erosions. Topical beta-blockers are contraindicated in the same situations where systemic beta-blockers are contraindicated.

They are generally as potent as pilocarpine but with no effect on the pupil or accommodation.

The intraocular pressure reducing effect of beta-blockers is additive to other agents, apart from nonselective adrenergic agonists.

The summary of product characteristics must be consulted before using drugs mentioned.

Last reviewed 01/2018