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We investigated the long-term clinical effects of a nipradilol ophthalmic solution on normal-tension glaucoma.Among normal tension glaucoma patients who consulted the Nara Medical University Hospital or 2 affiliated hospitals between November 2001 and August 2002, we prospectively examined intraocular pressure-decreasing effects, the deterioration of visual field defects, and the appearance of side effects in 46 patients who underwent single therapy with a nipradilol ophthalmic solution. We evaluated intraocular pressure at 6-month intervals. The deterioration of visual field defects was assessed based on a 3-dB or more decrease in the mean deviation measured using the Humphrey Field Analyzer 30-2 program.The 60 months intraocular pressure value after administration of nipradilol ophthalmic solution was significantly lower than the pretreatment value. The deterioration of visual field defects was examined using the Kaplan-Meier life table. The survival rate after 60 months was 82.4%. In 4 of the 46 patients, administration of the nipradilol ophthalmic solution was discontinued due to side effects.Long-term therapy with a nipradilol ophthalmic solution may be useful for treating normal-tension glaucoma.