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This paper is of interest only because it reports on the first-in-class commercially available rho kinase inhibitor. Much has been written about this class of drugs, and need not be repeated here. This particular iteration is an effective ocular hypotensive, albeit not as effective as our other major first-line drugs, i.e., prostaglandin F2a agonists and B2-adrenergic antagonists. Its additivity to these other agents would be of interest, as of course will its long-term efficacy and tolerability and adherence profile, both in Japan and elsewhere. Of note, the references are nearly all to Japanese work. Our Japanese colleagues have indeed done a lot in this arena, but so have many others in the arenas of the underlying relevant basic and translational science and clinical development. This should by no means be viewed as a 'Japanese' class of drugs.