Timolol in maintenance treatment of ocular hypertension and glaucoma

The hypotensive effect of Timolol eye drops (0.25 and 0.50%) in maintenance treatment of 64 patients with elevated intraocular pressure has been studied. The patients were treated for a period of mean 13 months. In 44 patients mostly comprising ocular hypertensives, a significant reducation in IOP (32%) could be maintained with Timolol alone (P less than 0.001). In patients with a high starting baseline pressure of previous maladjustable glaucoma it was necessary to start combined treatment. Pilocarpine, epinephrine or acetazolamide appeared to have additive pressure-lowering effect to Timolol. A significant correlation was present between pre-treatment and Timolol treated intraocular pressures. Thus a pre-treatment IOP above 25 mmHg may indicate a critically hypotensive effect below an IOP of 20 mmHg with Timolol alone. No significant interfernce with visual acuity, pupullary size, blood pressure, or pulse rate was noted. Existing visual field defects in three patients were slightly aggravated and in four patients, with a pathological optic disc, visual field loss developed. In seven patients transient sensations of dry eyes and rose-bengal staining dots on the cornea developed.