Intraocular pressure reduction during treatment with pilocarpine and systemic propranolol. A comparative double-masked study.

Propranolol, pilocarpine, and placebo were tested on eight patients with ocular hypertension. The trial was performed in a randomized double-masked cross-over manner utilizing the double dummy technique. After 1 week's treatment with 40 mg propranolol administered orally twice daily a statistically significant decrease in intraocular pressure (IOP) was seen. Also after application of 2% pilocarpine eyedrops three times a day IOP was significantly reduced. Propranolol decreased the IOP to about the same extent as pilocarpine. Simultaneous administration of propranolol and pilocarpine caused a further decrease in IOP which was statistically significant compared with the corresponding values during administration of pilocarpine alone. The combination of pilocarpine and propranolol lowered IOP slightly more than propranolol alone. The difference was not, however, statistically significant. During treatment with propranolol a significant decrease in heart rate was observed and a slight reduction of systemic blood pressure. It is concluded that propranolol can additively decrease IOP during treatment with pilocarpine.