Timolol in Uncontrolled Childhood Glaucomas

Thirty-four patients with childhood glaucoma who had difficult management problems in spite of conventional glaucoma medications were entered into an investigational protocol designed at a time when timolol was not available commercially. Since controlled studies in adult glaucoma had demonstrated the efficacy of timolol, a trial of the drug in these difficult childhood cases seemed justified. The study was approved by the Human Studies Committees of the Children's Hospital Medical Center and the Massachusetts Eye and Ear Infirmary, Boston, MA. These children have been followed for periods up to 2 1/2 years. In general, timolol was added to the maximum tolerated medical therapy. Definite improvement was noted in 10 patients, modest or equivocal improvement in 11, and in 13 no substantial benefit to their course occurred when timolol was added. Youngsters over 5 years of age showed an average reduction in resting pulse rate of 6 beats/minute similar to that previously found in adult patients. Under 5 years of age no change in the resting pulse rate could be detected. One patient was discontinued from timolol for a possible adverse effect. The experience particularly in very young children is still quite limited, but the beneficial effects observed warrant further evaluation.