NIGHTMARES FROM TOPICAL TIMOLOL EYE DROPS: A CASE REPORT

Main Article Content

Yousaf Jamal Mahsood
Saima Farooq

Abstract

Topical timolol eyedrops are frequently used as medical treatment of glaucoma. They decrease the production of aqueous humor by blocking the beta adrenergic receptors of ciliary body. Although systemic absorption of eyedrops is negligible, still it can cause some serious side effects like bradycardia, heart block, bronchospasm, confusion and hypotension. We present a case who developed nightmares with use of topical beta-blockers. He was a chronic case of primary open angle glaucoma whose target intraocular pressure (IOP) couldn’t be achieved with latanoprost alone, the first line drug, so we put him on topical timolol twice daily dosage to further decrease the IOP. On his follow-up visit he complained about bad dreams since starting timolol eye drops. This case report will add to the list of already known other side effects of timolol usage in glaucoma patients.

Article Details

How to Cite
Mahsood, Y., and S. Farooq. “NIGHTMARES FROM TOPICAL TIMOLOL EYE DROPS: A CASE REPORT”. KHYBER MEDICAL UNIVERSITY JOURNAL, Vol. 12, no. 3, Sept. 2020, pp. 251-2, doi:10.35845/kmuj.2020.20158.
Section
Case Report

References

1. Heijl A, Leske MC, Bengtsson B, Hyman L, Bengtsson B, Hussein M, et al. Reduction of intraocular pressure and glaucoma progression: results from Early Manifest Glaucoma Trial. Arch Ophthalmol 2002;120(10):1268-79. DOI: 10.1001/archopht.120.10.1268.
2. Leske MC, Heijl A, Hussein M, Bengtsson B, Hyman L, Komarrof E, et al. Factors for glaucoma progression and the effect of treatment: the Early Manifest Glaucoma Trial. Arch Ophthalmol 2003;121(1):48-56. DOI: 10.1001/archopht.121.1.48.
3. Zimmerman TJ, Baumann JD, Hetherington J. Side effects of timolol. Surv Ophthalmol 1983;28:243-51. DOI: 10.1016/0039-6257(83)90140-6.
4. Trope GE, Clark BA. Beta adrenergic receptors in pigmented ciliary processes. Br J Ophthalmol 1982;66(12):788-92. DOI: 10.1136/bjo.66.12.788.
5. Nanda T, Rasool N, Callahan AB, Stamper RL, Odel JG. Ophthalmic Timolol Hallucinations: A Case Series and Review of the Literature. J Glaucoma 2017;26(9):e214-6. DOI: 10.1097/IJG.0000000000000712.
6. Mort JR. Nightmare Cessation Following Alteration of Ophthalmic Administration of a Cholinergic and a Beta-Blocking Agent. Ann Pharmacother 1992. 26:914-6. DOI: 10.1177/106002809202600709.
7. Negi A, Thoung D, Dabbous F. Nightmares with topical beta-blocker. Eye (Lond) 2000;14(5):813-4. DOI: 10.1038/eye.2000.225.
8. Munroe WP, Rindone JP, Kershner RM. Systemic side effects associated with the ophthalmic administration of timolol. Drug Intell Clin Pharm 1985;19:85-9. DOI: 10.1177/106002808501900201.
9. Akingbehin T, Sunder P. Ophthalmic topical beta blockers: review of ocular and systemic adverse effects. J Toxicol Cutan Ocul Toxicol 1990;9:131-7
10. Lesar TS. Comparison of ophthalmic blocking agents. Clin Pharm 1987;6:451-63.