Page 37 - 21st Century Perspective - Glaucoma Supplement
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Because melanin pigments bind a portion of the beta-blocker medicine, we use the 0.5% formulation
for African-American patients (a higher percentage of the formulation is needed because of the
binding difference of the melanin pigments), and 0.25% for Caucasian and Asian patients.
Beta-blockers for the patient with asthma
Systemically, beta-blockers are consistently in the top 10 of most prescribed medications. This
clearly demonstrates their benefit to human medicine. The only relative contraindication for the use
of beta-blockers is in patients with asthma. Note that we use the word “relative” as opposed to
“absolute” contraindication. It is now well established that a sizable minority of patients with asthma
can safely use a topical beta-blocker. On those rare occasions when we need to prescribe a
beta-blocker in the treatment of a patient with asthma, we have a written confirmation in our medical
record from the patient’s asthma physician stating it is permissible for us to do so (Figure 21). This
has enabled us to safely and efficiently achieve target IOP in this small subset of patients.
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