Beta Blockers for Glaucoma

A lot of treatments today are designed to lower or control intraocular pressure (IOP), which may damage the optic nerve that transfers visual information to your brain.

Glaucoma eye drops are usually the first option over glaucoma surgery which may be quite effective at controlling IOP to prevent eye damage. If you are an eligible candidate for glaucoma eye drops, you may be prescribed more than one type to achieve the best IOP control.

However, you may not be eligible due to your specific individual health condition. Because any medication placed in the eye is absorbed into the conjunctival blood vessels on the eye’s surface. A small amount is bound to enter the bloodstream and adversely affect your heart rate and breathing.

Certain types of eye drops may worsen certain medical conditions of yours such as asthma, and certain glaucoma medicines may also interact with other common medications such as asthma.

Some experimental glaucoma medications explore new ways of controlling IOP, other treatments are intended to protect the optic nerve (neuroprotection) to prevent eye damage, potential vision loss or even blindness.

How Beta Blockers Work

Beta Blockers decrease the pressure inside your eyes by reducing how much fluid (aqueous humor) is produced in the eyes. Reducing pressure in the eyes, slows down optic nerve damage which greatly decreases the rate of vision loss.

Types of Beta Blockers

There are two classes of Beta Blockers which are non-selective and selective:

These are the 5 Non-Selective Beta Blockers:
  1. Levobunolol(Betagan)
  2. Timolol Hemihydrate (Betimol)
  3. Carteolol (Ocupress)
  4. Metipranolol (Optipranolol)
  5. Timolol Maleate (Timoptic) and Timolol Maleate Gel (Timoptic XE)

All of the above are used alone or with other prescribed medication to treat high pressure inside the eye due to glaucoma or other eye diseases. Lowering the high pressure inside the eyes helps prevent blindness.

Selective Beta Blockers

  • Betaxolol
    This is the only selective Beta Blocker that is used to treat high blood pressure. It has a better safety profile as compared to the non-selective Beta Blockers, particularly in terms of breathing symptoms. The eye pressure lowering effect is also slightly less with selective beta blockers.

Beta Blocker Medications/ Treatment

  • Alpha-Adrenergic Agonists

    This medication works by decreasing the rate of aqueous humor production and may be used alone, or other anti-glaucoma eye drops. FDA-approved medications at this level include Lopidine, Alphagan, and Alphagan-P.

  • Carbonic Anhydrase Inhibitors

    This medication works by reducing the rate of aqueous humor production. They are mostly used in combination with other anti-glaucoma and not alone. This drug is also used in oral form. FDA approved eye drops in this category include Trusopt and Azopt.

  • Parasympathomimetics

    This medication works by increasing the outflow of aqueous humor from the eye. Mostly used to control the IOP in narrow-angle glaucoma. These type of eye drops cause your pupils to constrict, which assists in opening the narrowed or blocked angles where drainage occurs.

  • Epinephrine

    This type of drug has a dual effect on your eye and work by decreasing the rate of aqueous humor production and increasing the outflow of aqueous humor from the eye.

  • Hyperosmotic Agents

    This drug is usually for people with a severely high IOP that must be reduced immediately before permanent; irreversible damage occurs to your optic nerve. For this reason alone, some ophthalmic pharmaceutical companies have produced “combination” eye drops that can include different anti-glaucoma medicines in the same bottle.

Side Effects of Beta Blockers

Most medicines have side effects so just to be clear, ask your pharmacist about the side effects of each medicine you consume. But mostly the benefits of the medicine are a lot more important than any minor side effects.

  • Stinging, aching, or redness in the eyes after using any eye drops
  • A slower heartbeat
  • Headaches
  • Feel tired, dizzy, off-balance, confused or depressed.

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