The following information is presented for educational purposes only.
Medical Marijuana Inc. provides this information to provide an
understanding of the potential applications of cannabidiol. Links to
third party websites do not constitute an endorsement of these
organizations by Medical Marijuana Inc. and none should be inferred.
Glaucoma is an eye disease where high intra-ocular pressure does
permanent damage to the optic nerve and causes vision loss. Studies have
shown marijuana decreases intraocular pressure.
Overview of Glaucoma
Glaucoma is an eye condition characterized by abnormally high pressure
in the eye, which causes damage to the optic nerve. According to Mayo
Clinic, glaucoma is one of the leading causes of blindness in the United
The vision loss caused by glaucoma cannot be recovered and the most
common form of glaucoma has zero warning signs. The damage to the optic
nerve is so gradual that most don’t notice the change in vision until
the condition is at an advanced stage. Early detection through regular
eye exams and a test that measures eye pressure, are necessary for
glaucoma to be diagnosed early enough before permanent damage can be
done. Those who are diagnosed with the condition will need regular
treatment to lower eye pressure for the rest of their lives.
The elevated eye pressure is the result of a buildup of fluid called
aqueous humor that flows throughout the eye. The fluid normally drains,
but when it’s overproduced or doesn’t drain properly, pressure builds.
There are two types of glaucoma conditions, including open-angle
glaucoma and acute angle-closure glaucoma. Open-angle glaucoma is the
most common form of the condition. Acute angle-closure glaucoma can be
accommodated with severe headache, eye pain, and nausea and vomiting.
Since glaucoma isn’t curable, treatment focus is on keeping the pressure
lower in the eye through medications.
Findings: Effects of Cannabis on Glaucoma
Over multiple decades, scientific research has proven that cannabinoids
are effective at decreasing intraocular pressure (Nadolska & Gos, 2008)
(Pinar-Sueiro, Rodriguez-Puertas & Vecino, 2011). In addition, the
compounds found in cannabis feature neuroprotection and vasodilation
properties, which further assist in the conservative treatment of
glaucoma (Nadolska & Gos, 2008) (Nucci, et al., 2008). The cannabinoids
found in cannabis, including tetrahydrocannabinol (THC), activate
endocannabinoid receptors CB1 and CB2 (Pinar-Sueiro, Rodriguez-Puertas &
Vecino, 2011). The endocannabinoid receptors located in the structures
of the eyes are responsible for the formation and outflow of aqueous
humor (Nadolska & Gos, 2008) (Nucci, et al., 2008).
Smoking cannabis has demonstrated through numerous studies that it can
be effective at lowering intraocular pressure. After inhaling THC,
participants with open-angle glaucoma in one study had their blood and
intra-ocular pressures decrease for three to four hours (Crawford &
Merritt, 1979). Another study found that smoking marijuana lowered blood
pressure, which led to a decrease in intra-ocular pressure within 60 to
90 minutes of inhalation (Merritt, et al., 1980). Yet
another study found that glaucoma patients experienced a lowering of
orthostatic blood pressure, but in just five minutes after smoking
marijuana (Merritt, Cook & Davis, 1982).
For patients interested in avoiding the psychoactive effects of smoking
cannabis, topical cannabinoid applications have also proven effective at
decreasing ocular pressure (Jarvinen, Pate & Laine, 2002). In one study,
applying THC oil directly to the eyes of participants with high blood
pressure resulted in the lowering of systolic blood pressure, which
researchers concluded may lead to a decrease in intra-ocular pressure
(Merritt, Olsen, Armstrong & McKinnon, 1981). In another, applying
cannabinoid directly to the eye decreased intraocular pressure within
the first 30 minutes with maximal reduction being reached in 60 minutes
(Porcella, Maxia, Gessa & Pani, 2001). One study that applied
cannabinoids directly to the eyes of rabbits recorded decreased
intra-ocular pressure within 1.5 hours of administration and the effects
lasted for more than 6 hours. In addition, the eye to which the
cannabinoid had not been administered also experienced a decrease in
intra-ocular pressure, but the effect lasted for 4 hours (Naveh, et al.,
States That Have Approved Medical Marijuana for Glaucoma
Currently, 26 states have approved medical marijuana for the treatment
of glaucoma. These states include: Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Florida, Hawaii, Illinois, Louisiana, Maine, Massachusetts, Michigan, Minnesota, Montana, Nevada, New
Pennsylvania, Oregon, Rhode
Island, Vermont and Washington.
Several states have approved
medical marijuana specifically to treat “chronic pain,” a symptom
commonly associated with glaucoma. These
states include: Alaska, Arizona, California, Colorado, Delaware, Hawaii, Maine, Maryland, Michigan, Montana, New
Mexico, Ohio, Oregon, Pennsylvania, Rhode
Island and Vermont.
The states of Nevada, New
Dakota, Montana, Ohio and Vermont allow
medical marijuana to treat “severe pain.” The states of Arkansas, Minnesota, Ohio, Pennsylvania and Washington have
approved cannabis for the treatment of “intractable pain.”
D.C., any condition can be approved for medical marijuana as long as
a DC-licensed physician recommends the treatment.
Recent Studies on Cannabis’ Effect on Glaucoma
Applying a cannabinoid topically to one eye of rabbits significantly
lowered intraocular pressure in that eye as well as the eye that was
A submicron emulsion of HU-211, a synthetic cannabinoid, reduces
intraocular pressure in rabbits.
Applying a cannabinoid directly to the human eye decreased
intraocular pressure within 30 minutes and reached maximal reduction
in the first 60 minutes.
The synthetic cannabinoid WIN55212-2 decreases the intraocular
pressure in human glaucoma resistant to conventional therapies.
Crawford, W.J., and Merritt, J.C. (1979, May). Effects of
tetrahydrocannabinol on arterial and intraocular hypertension. International
Journal of Clinical Pharmacology and Biopharmacy,
Facts About Glaucoma. (n.d.). National Eye Institute. Retrieved from https://nei.nih.gov/health/glaucoma/glaucoma_facts.
Glaucoma. (2015, September 15). Mayo
Retrieved from http://www.mayoclinic.org/diseases-conditions/glaucoma/basics/definition/con-20024042.
Jarvinen, T., Pate, D.W., and Laine, K. (2002, August). Cannabinoids in
the treatment of glaucoma. Pharmacology
Merritt, J.C., Cook, C.E., Davis, K.H. (1982). Orthostatic hypotension
after delta 9-tetrahydrocannabinol marihuana inhalation. Ophthalmic
Merritt, J.C., Crawford, W.J., Alexander, P.C., Andruze, A.L., and
Gelbart, S.S. (1980, March). Effect of marihuana on intraocular and
blood pressure in glaucoma. Ophthalmology,
Merritt, J.C., Olsen, J.L., Armstrong, J.R., and McKinnon, S.M. (1981,
January). Topical delta 9-tetrahydrocannabinol in hypertensive glaucomas. Journal
of Pharmacy and Pharmacology,
Nadolska, K., and Gos., R. (2008). Possibilities of applying
cannabinoids’ in the treatment of glaucoma. Klinika
Naveh, N., Weissman, C., Muchtar, S., Benita, S., and Mechoulam, R.
(2000, April). A submicron emulsion of HU-211, a synthetic cannabinoid,
reduces intraocular pressure in rabbits. Graefe’s
Archive for Clinical and Experimental Ophthalmology,
Nucci, C., Bari, M., Spano, A., Corasaniti, M., Bagetta, G., Maccarrone,
M., and Morrone, L.A. (2008). Potential roles of (endo)cannabinoids in
the treatment of glaucoma: from intraocular pressure control to
in Brain Research,
Pinar-Sueiro, S., Rodriguez-Puertas, R., and Vecino, E. (2011, January).
Cannabinoid applications in glaucoma. Archivos
de la Sociedad Espanola de Oftalmologia,
Porecella, A., Maxia, C., Gessa, G.L., and Pani, L. (2001, January). The
synthetic cannabinoid WIN55212-2 decreases the intraocular pressure in
human glaucoma resistant to conventional therapies. European
Journal of Neuroscience,
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