Abstract

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.