Hello I’m Dr. Croley and welcome to Case of the Day! Typically we talked about an interesting case but today we’re gonna shift focus a little bit. Had a person come in who has Glaucoma and who asked me about using Marijuana as a treatment for Glaucoma. And since there has been some new laws in different states that are passed, I thought it might be appropriate to go over what Marijuana has to do with Glaucoma, and can it treat Glaucoma.
And I thought I’ll be a little smart to come up with all kinds of terms and names for, you know, joint; refer different things of and list the names of different slang words for marijuana. I googled it and instead of having maybe 15 or 20, which I thought, ended up with several hundred words, as far as a slang for Marijuana goes. So it’s said enough to go to that realm.
But anyway, so first thing, Marijuana is a plant obviously, that the stems and flowers are crushed up and then taken either by eating brownies or by smoking. There’s over 400 different chemicals actually in the marijuana plant. Most of them are cannabinoids and the active ingredient, the major active ingredient, the psycho active part is THC. And so that’s the major component that is felt to have this action as far as the benefits for some people that it has for nausea and different things associated with people who have cancer and cancer treatment.
But there has been actually a lot of research done in Glaucoma in Marijuana in the past. And so we’ll go over a little bit about that. And so what is Glaucoma? In simple terms Glaucoma means that the pressure inside your eye is higher than what your eye can tolerate. Typically it’s usually higher than normal. The normal pressure is 10-21 millimeters of Mercury (mmhg). The fluid is produced by a gland behind your pupil. It goes in front of your lens to the pupil and fills out the front of your eye and drain through a meshwork here like cheesecloth into Schlemm’s Canal and then into your blood system. So there’s a constant production and a constant flow of fluid out of your eye.
We’re not sure exactly of the mechanism of how marijuana lowers the high pressure but it’s felt that the studies were done that the outflow, that is the flow out of your eye was increased, with the use of Marijuana. We think that’s the best, most likely mechanism of how it works. They tried actually making an eye drop out of THC and instilling that and it really didn’t lower the eye pressure very much, surprisingly. Then they also tried with ingesting marijuana and that lowered the eye pressure but not significantly. It turns out that actually smoking marijuana was the best route of lowering the high pressure and in fact in the studies it lowered the eye pressure by 25%. So it did have a significant reduction in the eye pressure. The problem is that its length of action was 3 or 4 hours and then the pressure would go back up.
That has been a major problem with trying to use marijuana to treat Glaucoma because of its short action. The other thing as far as using marijuana to treat glaucoma, this is a chronic life term, long term disease and so you’re gonna have to be doing this, you’re treating it for the rest of your life. If someone who may have cancer who may be terminal, then the other side effects are less important. But when someone who has to be treating glaucoma for a long time, Marijuana does increase your heart rate, it lowers the blood pressure, both diastolic and systolic. There’s a study recently in New Zealand that it may contribute to strokes. There may have an effect in your immune system. There’s evidence that it may be increasing cancer risk in women who are pregnant, it has caused some pregnancy problems. And then you have the psychotropic effects as well.
So if Marijuana doesn’t turn out to be a great choice as far as treating Glaucoma because it looks like it has to be smoked to be useful for Glaucoma. Then you would have to be smoking, that’s every 3 or 4 hours around the clock. So you have to wake up in the middle of the night and smoke your marijuana in order to keep your eye pressure low and no one’s gonna do that. And you would be actually basically stoned all the time. So couldn’t function in life. It might treat your Glaucoma but you would have trouble functioning as much as you would have to smoke to keep your eye pressure down.
So it turns out that marijuana does lower high pressure by 25% but it’s not a long term answer to treating Glaucoma. If they come out with something that does work as far as an eye drop or something else where you will still be able to function and wouldn’t give big psychotropic effect, then maybe someday there will be some way it could be used. Maybe there’s some other chemical in the plant that smoke combined with the THC that causes such pressure lowering effect but really nobody knows.
So if you have any questions about this or any other subject, please feel free to contact us through the website. And if not may God bless you with healthy eyes and great vision.