Purpose:To investigate the effect of topical β-blockers on the prevalence of depression among glaucoma patients.Design:Retrospective observational population-based cohort study.Participants:We reviewed the electronic medical records of all themembers in a district of the largest healthmaintenance organization in Israel(Central District of Clalit Health Services) who were older than 20 years(317 469 members) .Methods:We documented all antiglaucoma prescriptions(n=274 023) and all antidepressant prescriptions(n=16 948) filled by glaucoma patients in the district between January 1,2001 and December 31,2003.We included only those patients who filled at least 6 consecutive antiglaucoma prescriptions at least once every 2 months(n=6597;5846 [88.6% ] were treated with topical β-blockers) .Depressed patients were defined as patients that filled at least four prescriptions for antidepressants during the study period(n=810,12.3% of all glaucoma patients) .Main Outcome Measure:Relationship of topical β-blocker use and prevalence of depression among glaucoma patients.Results:No significant demographic differences were noted between glaucoma patients treated and not treated with topical β-blockers.Of those treated and not treated with β-blockers,12.2%(12.7% after age-adjustment) and 12.7%,respectively,were also receiving drug therapy for depression(P=0.7,chisquare test) .With stratification by age,treatment with topical β-blockers did not influence the prevalence of depression in any age group.Logistic regression analysis revealed a significant effect of age,place of birth,and gender on the prevalence of depression,but the prevalence of use of topical β-blockers had no significant effect.Conclusions:Use of topical β-blockers by glaucoma patients does not appear to increase the risk of depression in this population. Purpose: To investigate the effect of topical β-blockers on the prevalence of depression among glaucoma patients. Design: Retrospective observational population-based cohort study. Participants: We reviewed the electronic medical records of all themembers in a district of the largest health maintenance organization in Methods: We documented all antiglaucoma prescriptions (n ​​= 274 023) and all antidepressant prescriptions (n ​​= 16 948) filled by glaucoma patients in the Israel (Central District of Clalit Health Services) who were older than 20 years (317 469 members) district between January 1,2001 and December 31,2003.We included only those patients who filled at least 6 consecutive antiglaucoma prescriptions at least once every 2 months (n = 6597; 5846 [88.6%] were treated with topical β-blockers). Depressed patients were defined as patients that filled at least four prescriptions for antidepressants during the study period (n = 810, 12.3% of all glaucoma patients). Main Outcome Measure: Relationship of t Obical β-blocker use and prevalence of depression among glaucoma patients. Results: No significant demographic differences were observed between glaucoma patients treated and not treated with topical β-blockers. Of those treated and not treated with β-blockers, 12.2% (12.7% after age-adjustment and 12.7%, respectively, were also receiving drug therapy for depression (P = 0.7, chisquare test) .With stratification by age, treatment with topical β-blockers did not influence the prevalence of depression in any age group. Logistic regression analysis revealed a significant effect of age, place of birth, and gender on the prevalence of depression, but the prevalence of use of topical β-blockers had no significant effect. Conclusions: Use of topical β-blockers by glaucoma patients does not appear to increase the risk of depression in this population.