Comparison of types, mechanisms, and effects of beta blockers (BB) among glaucoma drugs

👁 Glaucoma Treatment – Beta Blockers (BB) Overview

Beta blockers (BB) are one of the first-line treatments for primary open-angle glaucoma (POAG),
commonly used alongside prostaglandin analogues.

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💡 Mechanism of Action

ReceptorEffectMnemonic

β2	Increases blood flow → ↑Aqueous production
BB	Blocks β2 → ↓blood flow → ↓Aqueous production	B↓ P↓

➡ BBs work by reducing aqueous humor production

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💊 Common BB Medications

DrugNotes

Timolol	Gold standard, systemic effect, pigment-sensitive
Betaxolol	Only β1-selective, possible neuroprotection
Levobunolol	Fast onset, strong efficacy
Carteolol	Less cardiovascular effects, cholesterol benefit
Metipranolol	Rarely used due to anterior uveitis risk

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📊 Meta-Analysis: 3-Month IOP Reduction

MedicationIOP Reduction (mmHg)

Timolol	3.7
Levobunolol	4.51
Betaxolol	2.24
Carteolol	3.44

✅ Timolol’s effect is the reference standard in clinical trials

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✅ Summary

• BBs lower IOP by decreasing aqueous humor production
• Choice depends on patient comorbidities & side-effect profile
• Next post: Systemic side effects of BB eye drops