Reduced ocular hypotensive effect of topical μ-blockers in glaucoma patients receiving oral μ-blockers

We reviewed all the records of the Glaucoma Service at the Massachusetts Eye and Ear Infirmary (N = 1,700) to assess the ocular hypotensive effect of topical μ-blockers in glaucoma patients receiving oral μ-blocker therapy. We identified 27 patients with elevated intraocular pressure who were using systemic μ-blockers before the initiation of topical μ-blocker therapy and compared them with 28 control patients with elevated intraocular pressure who were not using oral blockers when a topical μ-blocker was started. The intraocular pressure-lowering effect of topical blockers was shown to be significantly reduced in patients receiving oral μ-blockers (p < 0.02). μ-receptor selectivity of the oral and topical agents were found to be contributing factors in predicting the additive effect of topical μ-blocker therapy during systemic μ-blockade.