Ophthalmic Topical Beta Blockers: Review of Ocular and Systemic Adverse Effects

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Abstract
The success of medical treatment for the management of glaucoma depends largely on patients' compliance with the treatment regimen. Ophthalmic topical beta blockers have had a significant impact on the medical management of glaucoma by providing effective ocular hypotensive action coupled with improved patient compliance, which has been achieved by reduced frequency of instillation of the eye drops and minimal side effects. This paper reviews the wide range of ocular and systemic adverse effects associated with the use of ophthalmic beta blockers and highlights the specific population groups at increased risk for these reactions. Clinicians may, however, continue to take advantage of the promise shown by beta blockers to reduce intraocular pressure with minimal adverse reactions by their selective use in patients with glaucoma. Other precautionary measures to minimize the frequency and severity of systemic adverse effects related to topical beta blockade are discussed. Many of the newer ophthalmic topical beta blockers have fewer side effects, but the use of these drugs in patients with glaucoma is nevertheless indicated only after careful assessment of the individual patient's medical state. Brief mention is made of the mechanism of action of beta blockers, their pharmacologic properties, and possible interaction with other drugs.

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