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
