12 doctors weighed in:

What is the importance of pressing near the eye (punctal occlusion) after taking eye drops for glaucoma? Instructions for 0.5% timolol include "punctal occlusion." is this a standard instruction for anyone using timolol? Or might it have been written by

12 doctors weighed in
Dr. Douglas Liva
Ophthalmology
5 doctors agree

In brief: Yes

Punctal occlusion increases ocular penetration and reduces systemic absorption which can be a concern in certain individuals sensitive to beta blockers.
Closing the eye gently for 5 minutes accomplishes the same thing as puntal occlusion and is more comfortable to perform.

In brief: Yes

Punctal occlusion increases ocular penetration and reduces systemic absorption which can be a concern in certain individuals sensitive to beta blockers.
Closing the eye gently for 5 minutes accomplishes the same thing as puntal occlusion and is more comfortable to perform.
Dr. Douglas Liva
Dr. Douglas Liva
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Dr. Jeffrey Whitman
Ophthalmology
2 doctors agree

In brief: This

This is not mandatory but it will decrease the amount of drug getting into your system and increase the amount of drug getting into the eye.
If puncutal pressure bothers you or if not done does not bother you systemically (no symptoms), it is not necessary.

In brief: This

This is not mandatory but it will decrease the amount of drug getting into your system and increase the amount of drug getting into the eye.
If puncutal pressure bothers you or if not done does not bother you systemically (no symptoms), it is not necessary.
Dr. Jeffrey Whitman
Dr. Jeffrey Whitman
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Dr. William Goldstein
Ophthalmology
2 doctors agree

In brief: Punctal

Punctal occlusion is advised to minimize side effects.
Blocking the outflow of the medication by holding closed the 'drain' that opens into your nose from your eyes keeps the medicine in your eye longer. This allows more medicine to absorb where it is needed, and less of it to drain into the nose, and then into the body. So blockage of outflow may decrease side-effects, and increase usefulness by allowing more of it to soak into your eye. As an aside, timolol has the most probability of causing side effects in the rest of the body, especially the lungs. The newer drops called prostaglandins are safer and as or more effective in lowering pressure.

In brief: Punctal

Punctal occlusion is advised to minimize side effects.
Blocking the outflow of the medication by holding closed the 'drain' that opens into your nose from your eyes keeps the medicine in your eye longer. This allows more medicine to absorb where it is needed, and less of it to drain into the nose, and then into the body. So blockage of outflow may decrease side-effects, and increase usefulness by allowing more of it to soak into your eye. As an aside, timolol has the most probability of causing side effects in the rest of the body, especially the lungs. The newer drops called prostaglandins are safer and as or more effective in lowering pressure.
Dr. William Goldstein
Dr. William Goldstein
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Dr. John Kim
Ophthalmology
1 doctor agrees

In brief: Timolol

Timolol belongs to a class of medication called beta-blockers and has side effects just like any other medicine.
One of the more concerning side effect is the ability of the beta-blockers to constrict the air passage ways. For most people this is not an issue but if you have an asthma it is advised you obtain different class of medicine. There are many other potential side effects with beta-blockers, to minimize these effects patient can press on the punctum to limit the medicine from entering the body. Fortunately, there are many other class of eye drops for treating glaucoma. You should discuss with your ophthalmologist the option you have regarding the drops.

In brief: Timolol

Timolol belongs to a class of medication called beta-blockers and has side effects just like any other medicine.
One of the more concerning side effect is the ability of the beta-blockers to constrict the air passage ways. For most people this is not an issue but if you have an asthma it is advised you obtain different class of medicine. There are many other potential side effects with beta-blockers, to minimize these effects patient can press on the punctum to limit the medicine from entering the body. Fortunately, there are many other class of eye drops for treating glaucoma. You should discuss with your ophthalmologist the option you have regarding the drops.
Dr. John Kim
Dr. John Kim
Thank
Dr. Tim Conrad
Ophthalmology

In brief: Very

I am a big proponent of nasolacrimal obstruction (nldo) for all glaucoma drops.
I have had many patients come to me who were not in control of their pressures. By just instructing proper drop installation including nldo, many of them had dramatic lowering of pressure without having to add any medication.

In brief: Very

I am a big proponent of nasolacrimal obstruction (nldo) for all glaucoma drops.
I have had many patients come to me who were not in control of their pressures. By just instructing proper drop installation including nldo, many of them had dramatic lowering of pressure without having to add any medication.
Dr. Tim Conrad
Dr. Tim Conrad
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Dr. Emil Chynn
Ophthalmology - LASIK Surgery

In brief: It's

It's to decrease systemic absorption and increase efficacy in the eye.
I'd get punctal occlusion by plugs if i were you. It's easier and more effective and also solves dry eyes.

In brief: It's

It's to decrease systemic absorption and increase efficacy in the eye.
I'd get punctal occlusion by plugs if i were you. It's easier and more effective and also solves dry eyes.
Dr. Emil Chynn
Dr. Emil Chynn
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