A topical beta-blocker may be prescribed for the treatment of open-angle glaucoma. Systemic absorption can occur which can result in bradycardia.

Rationale for use in glaucoma: reduction in formation of aqueous humor


Implicated beta-blockers include:

(1) timolol

(2) levobunolol


Clinical features:

(1) therapy with an ophthalmic beta-blocker

(2) development of bradycardia with heart rate < 60 beats per minute

(3) variable first-degree sinoatrial block

(4) variable syncope

(5) exclusion of underlying heart disease

(6) normal heart rate after discontinuation of the beta-blocker

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