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Case report reveals carteolol eye drops can induce second- or third-degree atrioventricular block, indicating caution in usage.
Ophthalmic beta-blocker carteolol can rarely cause cardiovascular effects such as bradycardia, heart block, and hypotension. We report a case of carteolol eye drops induced atrioventricular (AV) block. A 76-year-old man with type 2 diabetes developed exercise-induced second-degree AV block, which improved after discontinuing carteolol eye drops in the unilateral eye. Six months later, third-degree AV block recurred due to inadvertent reuse of carteolol eye drops in bilateral eyes despite its prohibition. A seven-day patch electrocardiogram (ECG) monitor showed AV conduction returned to a 1:1 ratio after discontinuation of eye drops. The pacemaker implantation was deferred, and he is currently under close follow-up. Depending on the amount administered to a unilateral eye or bilateral eyes, topical carteolol eye drops can cause second- or third-degree AV block.
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Yoshioka et al. (2025) studied this question.
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