The treatment of glaucoma: role of beta-blocking agents

The sudden development of a red painful eye with blurred vision may be an acute attack of angle closure glaucoma which requires emergency attention. Once the attack is controlled with medication, surgical intervention with a peripheral iridectomy is indicated to relieve relative pupillary block. Eyes subject to angle closure glaucoma are anatomically different with 'crowded' anterior segments. In contrast, open angle glaucoma (the more common form) may progress to near blindness without symptoms. Routine screening of intraocular pressure is, therefore, necessary to make the diagnosis before extensive irreparable damage has occurred. Surgery for open angle glaucoma carries risks of cataract and infection, and is unpredictable. Open angle glaucoma patients are usually treated chronically with specific medications. Beta-Adrenoceptor blocking agents appear to provide a significant new addition to the currently available antiglaucoma medications.