Skip to main content

Advertisement

SpringerLink
Log in

Ocular β-Blockers in Glaucoma Management

Clinical Pharmacological Aspects

  • Review Article
  • Clinical Pharmacology
  • Published:
Drugs & Aging Aims and scope Submit manuscript

Summary

Topical β-blockers reduce the intraocular pressure (IOP) by blockade of sympathetic nerve endings in the ciliary epithelium causing a fall in aqueous humour production. Two types of topical β-blockers are available for use in glaucoma: nonselective, which block both β1- and β2-adrenoceptors; and cardioselective, which block only β1-receptors.

Of the β-Blockers commercially available, timolol, levobunolol, metipranolol and Carteolol are nonselective, and betaxolol is cardioselective. Twice-daily timolol is probably the most effective agent in lowering IOP, although levobunolol is equally effective and can be used once daily with little difference in effect. Carteolol is used twice daily and any theoretical advantage in diminished side effects confered by its partial β-agonist activity compared with timolol has not been fully substantiated. Metipranolol is effective twice daily and does not have partial β-agonist activity. Betaxolol has an effect comparable to timolol in lowering IOP, but is less effective in some patients.

β-Blockers can be used with other antiglaucoma medications, but their combined action with epinephrine (adrenaline) is suspect, particularly in the case of the nonselective β-blockers, and the effect should be assessed in patients on an individual basis. Local stinging can be a problem in some patients with betaxolol. The most serious side effects of β-blockers are the exacerbation of chronic obstructive airways disease with nonselective agents and the precipitation of bron-chospasm in some patients. Betaxolol seems relatively free of adverse respiratory effects, although this may be dose-related and extreme caution should still be exercised in patients with any history of respiratory illness. Because of the lower risk of precipitating side effects, betaxolol is probably the β-blocker of first choice for use in glaucoma; timolol or levobunolol are reserved for patients who do not respond satisfactorily to betaxolol and are quite free of respiratory disease.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Airaksinen PJ. The long-term hypotensive effect of timolol maleate compared with the effect of pilocarpine in simple and capsular glaucoma. Acta Ophthalmologica 57: 425–434, 1979

    PubMed  CAS  Google Scholar 

  • Airaksinen PJ, Valkonen R, Stenborg T, Takki K, Klemetti A, et al. A double-masked study of timolol and pilocarpine combined. American Journal of Ophthalmology 104: 587–594, 1987

    PubMed  CAS  Google Scholar 

  • Akingbehin T, Villada JR. Metipronolol-associated granulomatous anterior uveitis. British Journal of Ophthalmology 75: 519–523, 1991

    PubMed  CAS  Google Scholar 

  • Allen RC, Epstein DL. A double-masked clinical trial of betaxolol and timolol in glaucoma patients. Investigative Ophthalmology and Visual Science 23 (Suppl. 40): 1982

    Google Scholar 

  • Allen RC, Epstein DL. Additive effect of betaxolol and epinephrine in primary open angle glaucoma. Archives of Ophthalmology 104: 1178–1184, 1986

    PubMed  CAS  Google Scholar 

  • Allen RC, Hertzmark E, Walker AM, Epstein DL. A double-masked comparison of betaxolol vs timolol in the treatment of open-angle glaucoma. American Journal of Ophthalmology 101: 535–541, 1986

    PubMed  CAS  Google Scholar 

  • Allen RC, Robin AL, Long D, Novack GD, Lue JC, et al. A combination of levobunolol and dipivefrin for the treatment of glaucoma. Archives of Ophthalmology 106: 904–907, 1988

    PubMed  CAS  Google Scholar 

  • Anderson DR. Glaucoma: the damage caused by pressure. XLVI Edward Jackson Memorial Lecture. American Journal of Ophthalmology 108: 485–495, 1989

    PubMed  CAS  Google Scholar 

  • Andréasson S, Jensen KM. Effect of pindolol on intraocular pressure in glaucoma: pilot study and randomised comparison with timolol. British Journal of Ophthalmology 67: 228–230, 1983

    PubMed  Google Scholar 

  • Ashburn FS, Gillespie JE, Kass MA, Becker B. Timolol plus maximum tolerated antiglaucoma therapy: a one-year followup study. Survey of Ophthalmology 23: 389–394, 1979

    PubMed  Google Scholar 

  • Atkins JM, Pugh BR, Timewell RM. Cardiovascular effects of topical beta-blockers during exercise. American Journal of Ophthalmology 99: 173–175, 1985

    PubMed  CAS  Google Scholar 

  • Ball S. Congestive heart failure from betaxolol. Archives of Ophthalmology 105: 320, 1987

    PubMed  CAS  Google Scholar 

  • Battershill PE, Sorkin EM. Ocular metipranolol. Drugs 36: 601–615, 1988

    PubMed  CAS  Google Scholar 

  • Beasley CH, Cagle GD, McDonald TO. Long-term efficacy and safety of betaxolol 0.5% ophthalmic solution. New Trends in Ophthalmology 2: 95–97, 1987

    Google Scholar 

  • Bengtsson B. Aspects of the epidemiology of chronic glaucoma. Acta Ophthalmologica Supplementum 146: 1–48, 1981

    PubMed  Google Scholar 

  • Bensinger RE, Keates EU, Gofman JD, Novack GD, Duzman E. Levobunolol: a three-month efficacy study in the treatment of glaucoma and ocular hypertension. Archives of Ophthalmology 103: 375–378, 1985

    PubMed  CAS  Google Scholar 

  • Berger WE. Betaxolol in patients with glaucoma and asthma. American Journal of Ophthalmology 103: 600–601, 1987

    PubMed  CAS  Google Scholar 

  • Berlin I, Marcel P, Uzzan B, Millon D, Le Hoang P, et al. A single dose of three different ophthalmic beta-blockers antagonizes the chronotropic effect of isoproterenol in healthy volunteers. Clinical Pharmacology and Therapeutics 41: 622–626, 1987

    PubMed  CAS  Google Scholar 

  • Berrospi AR, Leibowitz HM. A new β-adrenergic blocking agent for treatment of glaucoma. Archives of Ophthalmology 100: 943–946, 1982

    PubMed  CAS  Google Scholar 

  • Berry DP, Van Buskirk EM, Shields MB. Betaxolol and timolol: a comparison of efficacy and side effects. Archives of Ophthalmology 102: 42–45, 1984

    PubMed  Google Scholar 

  • Berson FG, Cohen HB, Foerster RJ, Lass JH, Novack GD, et al. Levobunolol compared with timolol for the long-term control of elevated intraocular pressure. Archives of Ophthalmology 103: 379–382, 1985

    PubMed  CAS  Google Scholar 

  • Björnsson G. The primary glaucoma in Iceland. Acta Ophthalmologica Supplementum 91: 1–99, 1967

    Google Scholar 

  • Bleckmann H, Dorow P. Betaxolol vs placebo in ten patients with glaucoma and reactive airway disease. New Trends in Ophthalmology 2: 114–123, 1987

    Google Scholar 

  • Bloom E, Richmond C, Alvarado J, Polansky J. Betaxolol vs timolol: plasma radio-receptor assays to evaluate systemic complications of beta blocker therapy for glaucoma. Investigative Ophthalmology and Visual Science 26 (Suppl.): 125, 1985

    Google Scholar 

  • Boger WP, Puliafito CA, Steinert RF, Langston DP. Long-term experience with timolol ophthalmic solution in patients with open-angle glaucoma. Ophthalmology 85: 259–267, 1978

    PubMed  Google Scholar 

  • Boger WP, Steinert RF, Thomas JV. Timolol in the therapy of ‘Ocular Hypertension’. Survey of Ophthalmology 25: 195–202, 1980

    PubMed  Google Scholar 

  • Bonomi L, Steindler P. Effect of pindolol on intraocular pressure. British Journal of Ophthalmology 59: 301–303, 1975

    PubMed  CAS  Google Scholar 

  • Bonomi L, Zavarise G, Noya E, Michieletto S. Effects of timolol maleate on tear flow in human eyes. Albrecht Von Grafes Archiv fur Klinische und Experimentelle Ophthalmologie 213: 19–22, 1980

    CAS  Google Scholar 

  • Boozman FW, Carriker R, Foerster R, Allen RC, Novack GD, et al. Long-term evaluation of 0.25% levobunolol and timolol for therapy for elevated intraocular pressure. Archives of Ophthalmology 106: 614–618, 1988

    PubMed  Google Scholar 

  • Boudot JP, Cavero I, Fénard S, Lefèvre-Borg F, Manoury P, et al. Preliminary studies on SL 75212, a new potent cardioselective β-adrenoceptor antagonist. British Journal of Pharmacology (Proceedings) 66: 445P, 1979

    CAS  Google Scholar 

  • Brazier DJ, Smith SE. Ocular and cardiovascular response to topical Carteolol 2% and timolol 0.5% in healthy volunteers. British Journal of Ophthalmology 72: 101–103, 1988

    PubMed  CAS  Google Scholar 

  • Brenkman RF. Long-term hypotensive effect of atenolol 4% eye drops. British Journal of Ophthalmology 62: 287–291, 1978

    PubMed  CAS  Google Scholar 

  • Brogliatti B, Rolle T, Franzone M. Effects of topical betaxolol on ocular hypertensive or glaucomatous eyes. New Trends in Ophthalmology 2: 87–94, 1987

    Google Scholar 

  • Brooks AMV, Burdon JGW, Gillies WE. The significance of reactions to betaxolol reported by patients. Australian and New Zealand Journal of Ophthalmology 17: 353–355, 1989

    PubMed  CAS  Google Scholar 

  • Brooks AMV, Gillies WE, West RH. Betaxolol eye drops as a safe medication to lower intraocular pressure. Australian and New Zealand Journal of Ophthalmology 15: 125–129, 1987

    PubMed  CAS  Google Scholar 

  • Buckley MM-T, Goa KL, Clissold SP. Ocular betaxolol. A review of its pharmacological properties, and therapeutic efficacy in glaucoma and ocular hypertension. Drugs 40: 75–90, 1990

    PubMed  CAS  Google Scholar 

  • Caldwell DR, Salisbury CR, Guzek JP. Effects of topical betaxolol in ocular hypertensive patients. Archives of Ophthalmology 102: 539–540, 1984

    PubMed  CAS  Google Scholar 

  • Cavero I, Lefèvre-Borg F. Antihypertensive activity of betaxolol in conscious spontaneously hypertensive rats. British Journal of Pharmacology 78 (Proceedings): 141P, 1983

  • Cervantes R, Hernandez y Hernandez H, Frati A. Pulmonary and heart rate changes associated with nonselective beta-blocker glaucoma therapy. Journal of Toxicology — Cutaneous and Ocular Toxicology 5: 185–193, 1986

    Google Scholar 

  • Cher I. Transfer to timolol: selective use of a new mode of therapy. Australian Journal of Ophthalmology 8: 165–172, 1980

    PubMed  CAS  Google Scholar 

  • Chrisp P, Sorkin EM. Ocular Carteolol. A review of its pharmacological properties, and therapeutic use in glaucoma and ocular hypertension. Drugs & Aging 2: 58–77, 1992

    CAS  Google Scholar 

  • Cinotti A, Cinotti D, Grant W, Jacobs I, Galin M, et al. Levobunolol vs timolol for open-angle glaucoma and ocular hypertension. American Journal of Ophthalmology 99: 11–17, 1985

    PubMed  CAS  Google Scholar 

  • Clark JB, Brooks AMV, Mantzioros N, Gillies WE. A comparison of the efficacy of betaxolol and timolol in ocular hypertension with or without adrenaline. Australian and New Zealand Journal of Ophthalmology 17: 173–177, 1989

    PubMed  CAS  Google Scholar 

  • Coakes RL, Brubaker RF. The mechanism of timolol in lowering intraocular pressure. Archives of Ophthalmology 96: 2045–2048, 1978

    PubMed  CAS  Google Scholar 

  • Cohn JB. A comparative study of the central nervous system effects of betaxolol vs timolol. Correspondence. Archives of Ophthalmology 107: 633–634, 1989

    Google Scholar 

  • Collignon-Brach J. Early visual field changes with beta-blocking agents. Summary. Survey of Ophthalmology 33 (Suppl.): 429–430, 1989

    PubMed  Google Scholar 

  • Cyrlin MN, Thomas JV, Epstein DL. Additive effect of epinephrine to timolol therapy in primary open angle glaucoma. Archives of Ophthalmology 100: 414–418, 1982

    PubMed  CAS  Google Scholar 

  • David R, Sachs U. Timolol: long-term follow-up of patients with various types of glaucoma and ocular hypertension. Glaucoma 3: 323–325, 1981

    Google Scholar 

  • DeSantis L, Chandler M. Cardiac beta blockade after ocular instillation of beta adrenergic blockers in alert cynomolgus monkeys: safety profile for betaxolol. Investigative Ophthalmology and Visual Science 26: 227, 1985

    Google Scholar 

  • DeSantis L, Polansky JR, Bruce L. Relative differences in beta receptor activity between the cardioselective beta blocker, betaxolol, and nonselective beta blockers. In Blodi F, et al. (Eds) Proceedings of the XXVth International Congress of Ophthalmology, pp. 1501–1505, Kugler & Ghedini, Amsterdam, 1987

    Google Scholar 

  • Dickstein K. Comparison of the effect of timolol versus betaxolol Ophthalmic on cardiopulmonary exercise performance in healthy volunteers. Survey of Ophthalmology 33 (Suppl.): 457–458, 1989

    PubMed  Google Scholar 

  • Duff GR, Graham PA. A double-crossover trial comparing the effects of topical Carteolol and placebo on intraocular pressure. British Journal of Ophthalmology 72: 27–28, 1988

    PubMed  CAS  Google Scholar 

  • Duff GR, Newcombe RG. The 12-hour control of intraocular pressure on Carteolol 2% twice daily. British Journal of Ophthalmology 72: 890–891, 1988

    PubMed  CAS  Google Scholar 

  • Dunn TL, Gerber MJ, Shen AS, Fernandez E, Iseman MD, et al. The effect of topical ophthalmic instillation of timolol and be-taxolol on lung function in asthmatic subjects. American Review of Respiratory Disease 133: 264–268, 1986

    PubMed  CAS  Google Scholar 

  • Duzman E, Ober M, Scharrer A, Leopold IH. A clinical evaluation of the effects of topically applied levobunolol and timolol on increased intraocular pressure. American Journal of Ophthalmology 94: 318–327, 1982

    PubMed  CAS  Google Scholar 

  • Elliot MJ, Cullen PM, Phillips CI. Ocular hypotensive effect of atenolol (Tenormin, I.C.I.): a new beta-adrenergic blocker. British Journal of Ophthalmology 59: 296–300, 1975

    PubMed  CAS  Google Scholar 

  • Epstein DL, Krug JH, Hertzmark E, Remis LL, Edelstein DJ. A long-term clinical trial of timolol therapy versus no treatment in the management of glaucoma suspects. Ophthalmology 96: 1460–1467, 1989

    PubMed  CAS  Google Scholar 

  • Feghali JG, Kaufman PL. Decreased intraocular pressure in the hypertensive human eye with betaxolol, a β1-adrenergic antagonist. American Journal of Ophthalmology 100: 777–782, 1985

    PubMed  CAS  Google Scholar 

  • Fraunfelder FT, Barker AF. Respiratory effects of timolol. Correspondence. New England Journal of Medicine 311: 1441, 1984

    PubMed  CAS  Google Scholar 

  • Frumar KD, McGuinness R. A study of the intraocular pressure lowering effect of timolol and dipivalyl epinephrine. Transactions of the Ophthalmological Society of New Zealand 33: 27–29, 1981

    PubMed  CAS  Google Scholar 

  • Gerber SL, Cantor LB, Brater DC. Systemic drug interactions with topical glaucoma medications. Survey of Ophthalmology 35: 205–218, 1990

    PubMed  CAS  Google Scholar 

  • Gillies WE, West RH, Cebon L. A trial of timoptol (Timolol Maleate) in a clinical situation. Australian Journal of Ophthalmology 8: 173–175, 1980

    Google Scholar 

  • Gillies WE, West RH, Cebon L. Timoptol — three years on: a study of timolol maleate drops over a longer period. Australian Journal of Ophthalmology 11: 155–157, 1983

    PubMed  CAS  Google Scholar 

  • Goldberg I. Betaxolol. Australian and New Zealand Journal of Ophthalmology 17: 9–13, 1989

    PubMed  CAS  Google Scholar 

  • Gonzalez JP, Clissold SP. Ocular Levobunolol. A Review of its pharmacodynamic and pharmacokinetic properties, and therapeutic efficacy. Drugs 34: 648–661, 1987

    PubMed  CAS  Google Scholar 

  • Graham PA. Prevalence of glaucoma: population surveys. Transactions of the ophthalmological societies of the United Kingdom 98: 288–289, 1978

    PubMed  CAS  Google Scholar 

  • Grunwald JE. Effect of timolol maleate on the retinal circulation of human eyes with ocular hypertension. Investigative Ophthalmology and Visual Science 31: 521–526, 1990

    PubMed  CAS  Google Scholar 

  • Harris LS, Greenstein SH, Bloom AF. Respiratory difficulties with betaxolol. Correspondence. American Journal of Ophthalmology 102: 274–275, 1986

    PubMed  CAS  Google Scholar 

  • Hernandez y Hernandez H, Cervantes R, Frati A, Hurtado R, et al. Cardiovascular effects of topical glaucoma therapies in normal subjects. Journal of Toxicology — Cutaneous and Ocular Toxicology 2: 99–106, 1983

    Google Scholar 

  • Hollows FC, Graham PA. Intra-ocular pressure, glaucoma, and glaucoma suspects in a defined population. British Journal of Ophthalmology 50: 570–586, 1966

    PubMed  CAS  Google Scholar 

  • Holmin C, Krakau CET. Short term effects of timolol in chronic glaucoma: a double blind study using computerized perimetry. Acta Ophthalmologica 60: 337–346, 1982

    PubMed  CAS  Google Scholar 

  • Hoskins HD, Kass MA (Eds) Becker-Shaffer’s diagnosis and therapy of the glaucomas, pp. 455, CV Mosby, St Louis, 1989

    Google Scholar 

  • Høvding G, Aasved H. Timolol/pilocarpine combination eye drops in open angle glaucoma and in ocular hypertension: a controlled randomized study. Acta Ophthalmologica 65: 594–601, 1987

    PubMed  Google Scholar 

  • Huckauf H. Respiratory tolerance of oral betaxolol in partially reversible obstructive airways disease. In Morselli RL, et al. (Eds) Betaxolol and other β1-adrenoreceptor antagonists, pp. 205–211, Raven Press, New York, 1983

    Google Scholar 

  • Hugues FC, Julien D, Marche J. Influence of betaxolol and atenolol on airways in chronic obstructive lung diseases. In Morselli RL et al. (Eds) Betaxolol and other β1-adrenoreceptor antagonists, pp. 195–203, Raven Press, New York, 1983

    Google Scholar 

  • James IM. Pharmacologic effects of beta-blocking agents used in the management of glaucoma. Summary. Survey of Ophthalmology 33 (Suppl.): 453–454, 1989

    PubMed  Google Scholar 

  • Kahn HA, Leibowitz HM, Ganley JP, et al. The Framingham eye study. II. Association of ophthalmic pathology with single variables previously measured in the Framingham Heart study. American Journal of Epidemiology 106: 33–41, 1977

    PubMed  CAS  Google Scholar 

  • Kass MA. Timolol treatment prevents or delays glaucomatous visual field loss in individuals with ocular hypertension: a five-year, randomized, double-masked, clinical trial. Transactions of the American Ophthalmological Society 87: 598–618, 1989

    PubMed  CAS  Google Scholar 

  • Kass MA, Gordon MO, Hoff MR, Parkinson JM, Kolker AE, et al. Topical timolol administration reduces the incidence of glaucomatous damage in ocular hypertensive individuals: a randomized, double-masked, long-term clinical trial. Archives of Ophthalmology 107: 1590–1598, 1989

    PubMed  CAS  Google Scholar 

  • Katz IM, Berger ET. Efficacy and side effects of timolol and pilocarpine: a multicenter study. Glaucoma 3: 147–153, 1981

    Google Scholar 

  • Keates EU, Stone RA. Safety and effectiveness of concomitant administration of dipivefrin and timolol maleate. American Journal of Ophthalmology 91: 243–248, 1981

    PubMed  CAS  Google Scholar 

  • Korey MS, Hodapp E, Kass MA, Goldberg I, Gordon M, et al. Timolol and epinephrine: long-term evaluation of concurrent administration. Archives of Ophthalmology 100: 742–745, 1982

    PubMed  CAS  Google Scholar 

  • Krieglstein GK, Novack GD, Voepel E, Schwarzbach G, Lange U, et al. Levobunolol and metipranolol: comparative ocular hypotensive efficacy, safety, and comfort. British Journal of Ophthalmology 71: 250–253, 1987

    PubMed  CAS  Google Scholar 

  • LeBlanc RP, Krip G. Timolol: Canadian multicenter study. Ophthalmology 88: 244–248, 1981

    Google Scholar 

  • Le Jeunne C, Munera Y, Hugues F-C. Systemic effects of three β-blocker eyedrops: Comparison in healthy volunteers of β1-and β2-adrenoreceptor inhibition. Clinical Pharmacology and Therapeutics 47: 578–583, 1990

    PubMed  CAS  Google Scholar 

  • Lertora JJL, Mark AL, Johannsen UJ, Wilson WR, Abboud FM. Selective beta-1 receptor blockade with oral practolol in man. A dose-related phenomenon. Journal of Clinical Investigation 56: 719–724, 1975

    PubMed  CAS  Google Scholar 

  • Leske MC, Rosenthal J. Epidemiologic aspects of open-angle glaucoma. American Journal of Epidemiology 109: 250–272, 1979

    PubMed  CAS  Google Scholar 

  • Levobunolol Study Group. Levobunolol: a beta-adrenoreceptor antagonist effective in the long-term treatment of glaucoma. (Appended). Ophthalmology 92: 1271–1276, 1985

    Google Scholar 

  • Levobunolol Study Group. Levobunolol: a four-year study of efficacy and safety in glaucoma treatment. Ophthalmology 96: 642–645, 1989

    Google Scholar 

  • Levy NS, Boone L. Betaxolol. Investigative Ophthalmology and Visual Science 23 (Suppl.): 92, 1982

    Google Scholar 

  • Levy NS, Boone L. Effect of 0.25% betaxolol vs placebo. Glaucoma 5: 230–232, 1983

    Google Scholar 

  • Levy NS, Boone L, Ellis E. A controlled comparison of betaxolol and timolol with long-term evaluation of safety and efficacy. Glaucoma 7: 54–62, 1985

    Google Scholar 

  • Lin L-L, Galin MA, Obstbaum SA, Katz I. Longterm timolol therapy. Survey of Ophthalmology 23: 377–380, 1979

    PubMed  CAS  Google Scholar 

  • Liu G-S, Trope GE, Basu PK. A comparison of topical betoptic and timoptic on corneal re-epithelialization in rabbits. Journal of Toxicology — Cutaneous and Ocular Toxicology 6: 335–343, 1987

    Google Scholar 

  • Long D, Zimmerman T, Spaeth G, Novack G, Burke PJ, et al. Minimum concentration of levobunolol required to control intraocular pressure in patients with primary open-angle glaucoma or ocular hypertension. American Journal of Ophthalmology 99: 18–22, 1985

    PubMed  CAS  Google Scholar 

  • Long DA, Johns GE, Mullen RS, Bowe RG, Alexander D, et al. Levobunolol and betaxolol: a double-masked controlled comparison of efficacy and safety in patients with elevated intraocular pressure. Ophthalmology 95: 735–741, 1988

    PubMed  CAS  Google Scholar 

  • Lynch MG, Whitson JT, Brown RH, Nguyen H, Drake MM. Topical β-blocker therapy and central nervous system side effects: a preliminary study comparing betaxolol and timolol. Archives of Ophthalmology 106: 908–911, 1988

    PubMed  CAS  Google Scholar 

  • Martin FJ. Timolol maleate: a report from the Glaucoma Clinic, Sydney Eye Hospital. Australian Journal of Ophthalmology 8: 177–178, 1980

    PubMed  CAS  Google Scholar 

  • McMahon CD, Hetherington J, Hoskins HD, Shaffer RN. Timolol and pediatric glaucomas. Ophthalmology 88: 249–252, 1981

    PubMed  CAS  Google Scholar 

  • McMahon CD, Shaffer RN, Hoskins HD, Hetherington J. Adverse effects experienced by patients taking timolol. American Journal of Ophthalmology 88: 736–738, 1979

    PubMed  CAS  Google Scholar 

  • Mertè HI, Schnarr KD. Ophthalmic betaxolol: a twelve-week study in glaucoma patients. New Trends in Ophthalmology 2: 98–108, 1987

    Google Scholar 

  • Merte H-J, Stryz JR, Mertz M. Comparative studies of initial pressure reduction using metipranolol 0.3% and timolol 0.25% in eyes with open-angle glaucoma. Klinische Monatsblätter für Augenheilkunde 182: 286–289, 1983

    PubMed  CAS  Google Scholar 

  • Mills KB, Wright G. A blind randomised cross-over trial comparing metipranolol 0.3% with timolol 0.25% in open-angle glaucoma: a pilot study. British Journal of Ophthalmology 70: 39–42, 1986

    PubMed  CAS  Google Scholar 

  • Mishima S. Ocular effects of beta-adrenergic agents. XII Jules Stein lecture. Survey of Ophthalmology 27: 187–208, 1982

    PubMed  CAS  Google Scholar 

  • Nelson WL, Fraunfelder FT, Sills JM, Arrowsmith JB, Kuritsky JN. Adverse respiratory and cardiovascular events attributed to timolol ophthalmic solution. American Journal of Ophthalmology 102: 606–611, 1986

    PubMed  CAS  Google Scholar 

  • Nelson WL, Kuritsky JN. Early postmarketing surveillance of betaxolol hydrochloride, September 1985-September 1986. American Journal of Ophthalmology 103: 592, 1987

    PubMed  CAS  Google Scholar 

  • Neufeld AH. Experimental studies on the mechanism of action of timolol. Survey of Ophthalmology 23: 363–370, 1979

    PubMed  CAS  Google Scholar 

  • Neufeld AH. Epinephrine and timolol: how do these drugs lower intraocular pressure? Annals of Ophthalmology 13: 1109–1111, 1981

    PubMed  CAS  Google Scholar 

  • Novack GD. Ophthalmic beta-blockers since timolol. Survey of Ophthalmology 31: 307–327, 1987

    PubMed  CAS  Google Scholar 

  • Ofner S, Smith TJ. Betaxolol in chronic obstructive pulmonary disease. Journal of Ocular Pharmacology 3: 171–176, 1987

    PubMed  CAS  Google Scholar 

  • Ohno S, Ichiishi A, Matsuda H. Hypotensive effect of Carteolol on intraocular pressure elevation and secondary glaucoma associated with endogenous uveitis. Ophthalmologica 199: 41–45, 1989

    PubMed  CAS  Google Scholar 

  • Öhrström A. Dose response of oral timolol combined with adrenaline. British Journal of Opthalmology 66: 242–246, 1982

    Google Scholar 

  • Öhrström A, Pandolfi M. Regulation of intraocular pressure and pupil size by β-blockers and epinephrine. Archives of Ophthalmology 98: 2182–2184, 1980

    PubMed  Google Scholar 

  • Phillips CI. Timolol in operated closed-angle glaucoma. British Journal of Ophthalmology 64: 240–246, 1980

    PubMed  CAS  Google Scholar 

  • Phillips CI, Gore SM, Gunn PM. Atenolol versus adrenaline eye drops and an evaluation of these two combined. British Journal of Ophthalmology 62: 296–301, 1978

    PubMed  CAS  Google Scholar 

  • Phillips CI, Gore SM, Macdonald MJ, Cullen PM. Atenolol eye drops in glaucoma: a double-masked, controlled study. British Journal of Ophthalmology 61: 349–353, 1977

    PubMed  CAS  Google Scholar 

  • Phillips CI, Howitt G, Rowlands DJ. Propranolol as ocular hypotensive agent. British Journal of Ophthalmology 51: 222–226, 1967

    PubMed  CAS  Google Scholar 

  • Pillunat LE, Stodtmeister R. Pressure compliance test of the optic nerve head: influence of different antiglaucoma drugs (Summary). Survey of Ophthalmology 33 (Suppl.): 465–466, 1989

    PubMed  Google Scholar 

  • Radius RL. Use of betaxolol in the reduction of elevated intraocular pressure. Archives of Opthalmology 101: 898–900, 1983

    CAS  Google Scholar 

  • Rakofsky SI, Melamed S, Cohen JS, Slight JR, Spaeth G, et al. A comparison of the ocular hypotensive efficacy of once-daily and twice-daily levobunolol treatment. Ophthalmology 96: 8–11, 1989

    PubMed  CAS  Google Scholar 

  • Reiss GR, Brubaker RF. The mechanism of betaxolol, a new ocular hypotensive agent. Ophthalmology 90: 1369–1372, 1983

    PubMed  CAS  Google Scholar 

  • Rolle BB, Franzone M. Effects of topical betaxolol on ocular hypertensive or glaucomatous eyes. New Trends in Ophthalmology 2: 87–94, 1987

    Google Scholar 

  • Savelsbergh-Fillette MP, Demailly P. Levobunolol compared with timolol for control of elevated intraocular pressure. French Journal of Opthalmology 11: 587–590, 1988

    CAS  Google Scholar 

  • Schlecht LP, Brubaker RF. The effects of withdrawal of timolol in chronically treated glaucoma patients. Ophthalmology 95: 1212–1216, 1988

    PubMed  CAS  Google Scholar 

  • Schmitz-Valckenberg P, Jonas J, Brambring DF. Reductions in pressure with metipranolol 0.1%. Zeitschrift für Praktische Augenheilkunde 5: 171–175, 1984

    Google Scholar 

  • Schnaudigel O-E, Becker H, Fuchs H-B. Carteolol: Practice-oriented testing of efficacy and tolerance of a new beta-blocker for glaucoma therapy. Klinische Monatsblätter für Augenheilkunde 192: 248–251, 1988

    PubMed  CAS  Google Scholar 

  • Schoene RB, Abuan T, Ward RL, Beasley CH. Effects of topical betaxolol, timolol and placebo on pulmonary function in asthmatic bronchitis. American Journal of Ophthalmology 97: 86–92, 1984

    PubMed  CAS  Google Scholar 

  • Schoene RB, Abaun T, Ward RL, Beasley CH. Reply. American Journal of Ophthalmology 100: 493–494, 1985

    Google Scholar 

  • Seamone C, LeBlanc R, Saheb N, Novack G. Efficacy of twice-daily levobunolol in the treatment of elevated intraocular pressure. Canadian Journal of Ophthalmology 23: 168–170, 1988

    PubMed  CAS  Google Scholar 

  • Segal P, Skwierczyńska J. Mass screening of adults for glaucoma. Ophthalmologica 153: 336–348, 1967

    PubMed  CAS  Google Scholar 

  • Serle JB, Lustgarten JS, Podos SM. A clinical trial of metipranolol, a noncardioselective beta-adrenergic antagonist, in ocular hypertension. American Journal of Ophthalmology 112: 302–307, 1991

    PubMed  CAS  Google Scholar 

  • Silverstone D, Zimmerman T, Choplin N, Mundorf T, Rose A, et al. Evaluation of once-daily levobunolol 0.25% and timolol 0.25% therapy for increased intraocular pressure. American Journal of Ophthalmology 112: 56–60, 1991

    PubMed  CAS  Google Scholar 

  • Smith JP, Weeks RH, Newland EF, Ward RL. Betaxolol and ace-tazolamide: combined ocular hypotensive effect. Archives of Ophthalmology 102: 1794–1795, 1984

    PubMed  CAS  Google Scholar 

  • Smith RJ, Nagasubramanian S, Watkins R, Poinoosawmy D. Addition of timolol maleate to routine medical therapy: a clinical trial. British Journal of Ophthalmology 64: 779–781, 1980

    PubMed  CAS  Google Scholar 

  • Smith RJH, Blamires T, Nagasubramanian S, Watkins R, Poinoosawmy D. Addition of pindolol to routine medical therapy: a clinical trial. British Journal of Ophthalmology 66: 102–108, 1982

    PubMed  CAS  Google Scholar 

  • Smith SE, Smith SA, Reynolds F, Whitmarsh VB. Ocular and cardiovascular effects of local and systemic pindolol. British Journal of Ophthalmology 63: 63–66, 1979

    PubMed  CAS  Google Scholar 

  • Soll DB. Evaluation of timolol in chronic open-angle glaucoma: once a day vs twice a day. Archives of Ophthalmology 98: 2178–2181, 1980

    PubMed  CAS  Google Scholar 

  • Sommer A. Intraocular pressure and glaucoma. Editorial. American Journal of Ophthalmology 107: 186–188, 1989

    PubMed  CAS  Google Scholar 

  • Sonntag JR, Brindley GO, Shields MB. Effect of timolol therapy on outflow facility. Investigative Ophthalmology and Visual Science 17: 293–296, 1978

    PubMed  CAS  Google Scholar 

  • Sonty S, Schwartz B. The additive effect of timolol on open angle glaucoma patients on maximal medical therapy. Survey of Ophthalmology 23: 381–388, 1979

    PubMed  CAS  Google Scholar 

  • Spiritus EM, Casciari R. Effects of topical betaxolol, timolol, and placebo on pulmonary function in asthmatic bronchitis. Correspondence. American Journal of Ophthalmology 100: 492–493, 1985

    PubMed  CAS  Google Scholar 

  • Steinert RF, Thomas JV, Boger WP. Long-term drift and continued efficacy after multiyear timolol therapy. Archives of Ophthalmology 99: 100–103, 1981

    PubMed  CAS  Google Scholar 

  • Stewart RH, Kimbrough RL, Ward RL. Betaxolol vs timolol: a six-month double-blind comparison. Archives of Ophthalmology 104: 46–48, 1986

    PubMed  CAS  Google Scholar 

  • Stryz JR, Merté H-J. Comparison of different β-blockers in open angle glaucomas. In Greve et al. (Eds) Second European Glaucoma Symposium, Helsinki, 1984, pp. 119–123, Dr W. Junk Publishers, Dordrecht, 1985

    Google Scholar 

  • Thomas JV, Epstein DL. Timolol and epinephrine in primary open angle glaucoma: transient additive effect. Archives of Ophthalmology 99: 91–95, 1981

    PubMed  CAS  Google Scholar 

  • Thorson JC. Concomitant glaucoma therapy with dipivefrin and timolol maleate. Transactions of the Ophthalmological Society of New Zealand 33: 24–26, 1981

    PubMed  CAS  Google Scholar 

  • Trope GE, Liu G-S, Basu PK. Toxic effects of topically administered Betagan, Betoptic and Timoptic on regenerating corneal epithelium. Journal of Ocular Pharmacology 4: 359–366, 1988

    PubMed  CAS  Google Scholar 

  • Vale J, Gibbs ACC, Phillips CI. Topical propranolol and ocular tension in the human. British Journal of Ophthalmology 56: 770–775, 1972

    PubMed  CAS  Google Scholar 

  • Van Buskirk EM. Corneal anesthesia after timolol maleate therapy. American Journal of Ophthalmology 88: 739–743, 1979

    PubMed  Google Scholar 

  • Van Buskirk EM. Adverse reactions from timolol administration. Ophthalmology 87: 447–450, 1980

    PubMed  Google Scholar 

  • Van Buskirk EM, Weinreb RN, Berry DP, Lustgarten JS, Podos SM, et al. Betaxolol in patients with glaucoma and asthma. American Journal of Ophthalmology 101: 531–534, 1986

    PubMed  Google Scholar 

  • Van Buskirk EM, Weinreb RN, Berry DP, Lustgarten JS, Podos SM, et al. Reply. American Journal of Ophthalmology 103: 600–601, 1987

    Google Scholar 

  • Viggósson G, Björnsson G, Ingvason JG. The prevalence of open-angle glaucoma in Iceland. Acta Ophthalmologica 64: 138–141, 1986

    PubMed  Google Scholar 

  • Vukich JA, Leef DL, Allen RC. Betaxolol in patients with coexistant chronic open angle glaucoma and pulmonary disease. Investigative Ophthalmology and Visual Science 26 (Suppl.): 227, 1985

    Google Scholar 

  • Wandel T, Charap AD, Lewis RA, Partamian L, Cobb S, et al. Glaucoma treated with once-daily levobunolol. American Journal of Ophthalmology 101: 298–304, 1986

    PubMed  CAS  Google Scholar 

  • Weinreb RN, Ritch R, Kushner FH. Effect of adding betaxolol to dipivefrin therapy. American Journal of Ophthalmology 101: 196–198, 1986

    PubMed  CAS  Google Scholar 

  • Weinreb RN, Van Buskirk EM, Cherniack R, Drake MM. Long-term betaxolol therapy in glaucoma patients with pulmonary disease. American Journal of Ophthalmology 106: 162–167, 1988

    PubMed  CAS  Google Scholar 

  • Wettrell K, Wilke K, Pandolfi M. Topical atenolol versus pilocarpine: a double-blind study of the effect on ocular tension. British Journal of Ophthalmology 62: 292–295, 1978

    PubMed  CAS  Google Scholar 

  • Williams T, Ginther WH. Hazards of ophthalmic timolol. Correspondence. New England Journal of Medicine 306: 1485–1486, 1982

    PubMed  CAS  Google Scholar 

  • Worthen DM. Patient compliance and the ‘usefulness product’ of timolol. Survey of Ophthalmology 23: 403–406, 1979

    PubMed  CAS  Google Scholar 

  • Zimmerman TJ, Boger WP. The beta-adrenergic blocking agents and the treatment of glaucoma. Survey of Ophthalmology 23: 347–362, 1979

    PubMed  CAS  Google Scholar 

  • Zimmerman TJ, Harbin R, Pett M, Kaufman HE. Timolol and facility of outflow. Investigative Ophthalmology and Visual Science 16: 623–624, 1977

    PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Glaucoma Investigation and Research Unit, The Royal Victorian Eye and Ear Hospital, 394 Albert Street, East Melbourne, Victoria, 3002, Australia

    Anne M. V. Brooks & W. E. Gillies

Authors
  1. Anne M. V. Brooks
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. W. E. Gillies
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Brooks, A.M.V., Gillies, W.E. Ocular β-Blockers in Glaucoma Management. Drugs & Aging 2, 208–221 (1992). https://doi.org/10.2165/00002512-199202030-00005

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.2165/00002512-199202030-00005

Keywords

Search

Navigation