The introduction in 1979 of timolol eyedrops (Timoptol - MSD) was an important advance in the treatment of chronic open-angle glaucoma. Timolol’s relative lack of ocular unwanted effects,1 and its twice daily administration, makes it more acceptable than other eyedrops such as pilocarpine or adrenaline.2,3 But because it is absorbed through the nasal mucosa it can occasionally cause bradycardia and bronchospasm4 which may be fatal. It is also expensive. Carteolol (Teoptic) and betaxolol (Betoptic) are new ophthalmic β-blockers claimed to have a lower incidence of unwanted systemic effects. This is not claimed for metipranolol (Glauline) which is notably cheaper.
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