Case Series Review on Use of Topical Timolol in the Treatment of Superior Oblique Myokymia.

Abstract

Introduction: The treatment options available for Superior Oblique Myokymia (SOM) previously included surgery and systemic drugs, with the addition of beta blockers from the early 1990's. This case review aims to examine the efficacy of topical timolol (0.5%) as a treatment for SOM in the short and long term.

Methods: This is a retrospective case series review on a group of patients identified with this condition who have been assessed and treated with topical timolol 0.5% (off-label), within the same district and general hospital over a period of four years.

Results: Six patients were identified from the case review. Five out of the six patients were treated with the use of off label timolol 0.5%. One patient declined treatment due to other systemic conditions and another later discontinued treatment due to change in cardiac status. Two of the patients required increased dosage from OD to BD to achieve success initially. All the patients treated were symptom free at eight weeks and remained symptom free at six months follow-up. None of the patients in the cohort reported significant side effects.

Conclusion: This case series highlights the efficacy of the use of off label timolol 0.5% for the management of SOM with an 80% success rate for those treated with the drug.