A little over two decades ago topical ß blockers became the primary treatment for chronic open angle glaucoma. ß Blockers replaced cholinergics (primarily pilocarpine) despite the fact that ß blockers were seen as considerably more expensive. The advantage of ß blockers was their apparent increased effectiveness, and the minimal amount of local side effects. Despite the fact that systemic side effects associated with their use are not inconsiderable, ß blockers have remained the drug of choice for initial treatment of chronic open angle glaucoma. A controversy moderated by Ivan Goldberg addresses the question of whether ß blockers should now be replaced by some of the newer agents available for treatment of open angle glaucoma. What are these newer agents? They are primarily ₂ agonists, prostaglandin analogues and related drugs, and topical carbonic anhydrase inhibitors. Some of them appear to offer equal or perhaps even better hypotensive effect than ß blockers. Moreover, . . . [Full text of this article]

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