American journal of ophthalmology
-
To present an evidence-based review of the systemic adverse effects of beta-adrenergic blockers and recommend safety guidelines for use of ophthalmic beta-adrenergic blockers. ⋯ Many commonly presumed adverse beta-adrenergic blocker effects observed via systemic or ocular administration are not supported by published randomized clinical trials. Wide acceptance of such traditionally purported side effects has been largely due to propagation of isolated case reports and short series as well as personal communication felt to reflect expert opinion. Many more patients may be eligible to use these drugs. Obtaining a careful medical history and checking pulse rate and rhythm in the office should identify the vast majority of patients with potential cardiopulmonary contraindications.