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Abstract
At the time of their introduction, nearly 10 years ago, ophthalmic beta blockers offered an alternative to other topical agents such as pilocarpine or epinephrine in the treatment of glaucoma. The beta blockers were only required to be instilled twice daily, and they were free of many of the ocular side effects of pilocarpine and other topical agents. However, as with other topical agents, significant systemic side effects can occur, which can lead to undesirable effects in susceptible individuals. We present here the types of both ocular and systemic untoward effects reported for topical beta blockers, as well as a context for judging the benefit-risk ratio for their use.