In reply
We would like to thank Dr Alvarado for his interest in our study and his very thoughtful discussion. We similarly noted the low rate of ocular allergy associated with 0.2% brimonidine–0.5% timolol fixed-combination therapy relative to 0.2% brimonidine monotherapy.1 Although the dosing regimen was twice daily for the combination product as compared with 3 times daily for brimonidine alone, we agree with Dr Alvarado's assessment that the addition of timolol appears to play an important role in the reduced allergy rate, as the rate of allergy was still well below the previous 12-month reported rates with twice daily dosing of 0.2% brimonidine.2 This study during a 12-month period should provide a realistic assessment of the overall allergy rate with the fixed-combination product because the ocular allergy with brimonidine often develops early in the treatment process.3