Topical atenolol versus pilocarpine: a double-blind study of the effect on ocular tension.

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Abstract
Topical atenolol (a .beta.1-adrenoceptive antagonist), pilocarpine and placebo were tested in a randomized double-blind crossover trial of 8 patients with ocular hypertension. Atenolol (2% 3 times a day) caused a fall in intraocular pressure (IOP) comparable to that achieved by topical application of pilocarpine (2% 3 times a day). The decrease in IOP by each compound was demonstrable on the 2nd day of application and was significantly (P < 0.05) reduced on the 7th and 14th days of treatment. The combination of 2% pilocarpine and 2% atenolol administered 15 min apart (3 times a day) lowered the IOP significantly from the 2nd day of treatment, and this reduction persisted throughout the trial period of 14 days. This combined treatment lowered the IOP more than either substance alone. This further decrease was statistically significant only on the 14th day of treatment (atenolol vs. atenolol + pilocarpine, P < 0.05). No change of the episcleral venous pressure was observed after 14 days treatment with either atenolol or pilocarpine alone, or combined.