Transfer to timolol: selective use of a new mode of therapy

Many patients on long-term anti-glaucoma therapy were found to need better treatment because of lack of control and/or troublesome symptoms or signs. One hundred and ninety such patients with a wide range of glaucomas were observed during transfer to treatment with timolol maleate. This drug alone or in some combination, controlled two out of three patients. Some cases benefited from distinctive effects not easily provided by any other drug. Some patients were unresponsive and as time progressed an increasing number of early responders showed tachyphylaxis. As the result of experience in this series, timolol is not yet recommended for initial or cavalier use in all glaucomas or all patients. Because the drug is so new, special indications should be recognised by which timolol can be used selectively and with continuing caution for a further period.