Use of Betablockers in Glaucoma.

Beta blockers are the oldest known drugs used for the treatment of Glaucoma. Topical beta blockers like Timolol, Levobunolol act by blocking sympathetic nerve endings in the ciliary epithelium, thereby reducing the aqueous production. Timolol blocks both beta 1 and beta 2 receptors while Betaxolol is Cardioselectivve and block only Beta receptors.
Beta blockers should be ideally (and usually are) administered twice daily. Please check with your ophthalmic specialist for your specific dosage.
Beta blockers (especially Timolol) are absolutely contraindicated in patients with asthma and COPD. This is due to a potentia precipitate of bronchospasm(s).
Beta blockers can cause significant IOP reductions of up to 20-25%. They can, however, easily be used as an adjunct with other IOP lowering drugs without much interaction.
These drugs are generally well tolerated topically, but in the the long run may cause dry eyes and tachyphylaxis.
Systemic side effects are mainly related to cardio respiratory system. i.e bradycardia, arrythmias, heart failure, bronchospasm, hypotension, reduced exercise tolerance, impotence, depression, hyperlipidemia

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