Timolol Eyedrop-Induced Severe Bronchospasm

Abstract

A patient with glaucoma simplex chronic pulmonary obstruction was treated with the nonselective .beta.-adrenergic blocking agent timolol in ophthalmic solution of 0.25% for 1.5 yr, when he had daily asthma attacks. In a provocation test, forced expiratory volume in the 1st s was reduced by 56% and bradycardia was induced after application of 2 drops of timolol eyedrops 0.25%. The severe systemic side effects of timolol when used as eyedrops are related to their liver bypass and perhaps to the fast absorption from the cornea. When timolol ophthalamic solution is given for the 1st time to glaucoma patients with chronic obstructive pulmonary disease, they should be observed for 1 h with special attention given to difficulty in breathing.