The drug atlas
Ophthalmology/Topical beta-blocker (glaucoma)
Topical β-blockers
also: timolol · betaxolol · glaucoma drops
Overview
Glaucoma eye drops that reduce aqueous production. The catch: they are systemically absorbed, so the systemic β-blocker contraindications (asthma, heart block) still apply.
Mechanism
Block β-receptors on the ciliary epithelium → REDUCE aqueous humour PRODUCTION → lower IOP.
Indications
- Open-angle glaucoma / ocular hypertension
- Acute angle-closure glaucoma (part of the emergency combination)
The agents
Timololnon-selective
BD
Effective; systemically absorbed.
Betaxololβ₁-selective
Slightly safer in airways disease (still caution).
Adverse effects
Systemic β-blockade: bronchospasm, bradycardia, heart blockserious
Even eye drops are absorbed — punctal occlusion reduces it.
Ocular stinging, dry eyecommon
Cautions & contraindications
Asthma / COPDasthma
Bronchospasm — even topical.
Bradycardia / 2nd–3rd degree heart blockall
Interactions
- Additive with systemic β-blockers/rate-limiting drugs
Monitoring & kinetics
IOP; ask about airways/cardiac history before prescribing
Topical BD. Counsel on punctal occlusion (finger to inner canthus) to reduce systemic absorption.
Source: NICE NG81 — Glaucoma · BNF — Beta-blockers (eye)