Glaucoma can strike people of all ages but is most often found among those over 65. The most common form of glaucoma is chronic or open-angle glaucoma. It is characterized by increased pressure within the eye (intraocular pressure or IOP) which can cause damage to the optic nerve if not controlled effectively. Other types of glaucoma include narrow-angle and secondary. Treatment of narrow-angle glaucoma is primarily surgical. In approximately 90% of the open-angle and secondary glaucomas topical (eyedrop) preparations along with some oral medications can effectively control the disease, but at least 10% of all cases fail to be completely controlled by available prescriptive drugs. In some instances available glaucomic medications can cause side-effects such as headaches, kidney stones, burning of the eyes, blurred vision, cardiac arrhythmias, insomnia, and nervous anxiety. These side-effects may become so severe that the patient must discontinue use. Marijuana has shown promise as a possible glaucoma treatment in numerous published studies. In controlled studies at UCLA, it was discovered that patients smoking marijuana experienced, on average, a 30% drop in eye pressure. The reduction was dose related and lasted 4 to 5 hours. Dr. Robert Hepler, principal investigator in the UCLA study, concluded that cannabis may be more useful than conventional medications and may reduce eye pressure in a way that conventional medications do not, thus making marijuana a potential additive to the glaucoma patient’s regimen of available medication. Tolerance to conventional medications is a common problem in glaucoma control. The use of marijuana for additional IOP reduction could eliminate the need for surgical intervention. Glaucoma surgery costs Americans an estimated $8.8 million per year. Scientists have been working to develop a marijuana eyedrop for several years. Until recently, they concentrated on delta-9-THC, marijuana’s psychoactive ingredient. Some researchers, however, have begun to wonder if other constituents in the cannabis plant might be more effective in reducing IOP. This theory is bolstered by the few glaucoma patients who have continued, legal access to marijuana. In these cases, synthetic THC is only effective for a short period of time. Natural marijuana, however, consistently lowers IOP. A number of pharmaceutical companies are investigating drugs that are chemically similar to various constituents of cannabis for possible glaucomic applications. A West Indies pharmaceutical company has developed a synthetic marijuana eyedrop but this is unavailable in the U.S. …… The human eyeball is filled with fluid, which exerts pressure to keep the eyeball spherical. Glaucoma is a condition where the channels through which the fluid flows gradually become blocked, and the intraocular pressure gradually increases, causing increasing damage to the optic nerve, and gradual deterioration of vision. Glaucoma is the second-largest cause of blindness, and affects 1.5 % of 50-year olds and 5 % of seventy-year olds. Standard treatments have unpleasant or dangerous side effects, and have little effect on intraocular pressures in end-stage glaucoma. Cannabis however lowers intraocular pressures dramatically, with none of the serious side effects. Patients who find that standard medicines do not help their conditions report that smoking cannabis quickly restores their vision. Many long-term glaucoma patients have successfully maintained their sight using cannabis for 20 or 25 years, and avoided the gradual painfull deterioration to blindness that is otherwise enevitable. However older generations, who are most at risk of glaucoma do not appreciate the euphoric side effects of smoked or ingested cannabis. There is also concern about the effects on the cardio-vasculat system. There is hope that a cannabis-containing eyedrop could be developed in the future which would have no side effects but this is made difficult since cannabinoids are not water soluble. Ironically the discovery that cannabis lowers intraocular pressure was made accidentally during a police experiment. They were trying to discover if cannabis caused pupil dilation in users, so that they could detect and arrest them more easily!
Elvy Musikka is a woman in her mid-40′s who lives in Florida, USA. In 1988 she was acquitted of cannabis possession charges by using a medical necessity defence…… “In late February 1975 I went to see Dr. Rosenfeld, a general practitioner in the Ft. Lauderdale area. He concluded a very thorough examination and said my eyes had been stricken with glaucoma. My [intraocular fluid] pressures were in the high 40s [pressure in the low teens is normal], and Dr. Rosenfeld insisted I see an ophthalmologist immediately. His suspicions were confirmed and I was started on pilocarpine eyedrops. By the spring of 1976 the pilocarpine itself was becoming a problem. I began seeing circles but assumed they were a symptom of the glaucoma. Wearing contact lenses was uncomfortable and my pressures were going up. A new doctor suggested I consider marihuana because it was likely that otherwise I would go blind. He told me this as a friend, not a doctor; it was then that I began to realize that sometimes doctors have to choose between Hippocratic oaths and hypocritical laws. I was most fortunate this man had a heart. Blindness was not new to me. I was born blind, with congenital cataracts, and had my first eye surgery at five. Surgery then was very different from the laser surgery of today, and I was left with a lot of scar tissue. I wore very thick glasses until fourteen or so, when I had surgery on my left eye. Something went wrong and I lost most of my sight in that eye. But with 20/200 vision in the right eye and the help of contact lenses, I had gotten along quite well, until this most recent finding. Iwas uncomfortable with the thought of taking marihuana, a drug I had been misinformed to believe was as dangerous and addictive as heroin. Because of my anxiety, the first time I used it I became sick to my stomach. I find that particularly amusing now, as I have discovered that it is very effective in preventing and alleviating nausea. I have also discovered that, like myself at first, some people feel paranoid after using marihuana, but now I wonder whether this is an effect of the plant itself or due to long-standing myths about its dangerousness. I don’t get paranoid using it any more-maybe that is a clue? That summer I discovered something curious. One day I visited the doctor scared to death because my friend Jerry and I had spent an awful lot of the night before drinking champagne. I presumed it would have increased my pressures, and was very surprised to find that they were 12 and 13. My doctor explained that downers such as alcohol, marihuana, and Demerol bring pressures down. He felt the safest of the three was marihuana. I was having a terrible time smoking it, so my doctor and I decided it would be best for me to take it in brownies instead. He warned I would need a bit more than smoking. He gave me a recipe that called for an ounce of marihuana to yield a batch of twenty-four brownies-a twelve-day supply. I didn’t know where to go for marihuana and didn’t always have access to it. Once my pressures were so high my doctor obtained some for me. It was handled through his secretary. Oh, that poor woman! How she shook! Her hands were ice cold when she handed me the bag. I thanked God for these compassionate people. I knew the street value was thirty to forty dollars an ounce but she only took fifteen dollars. That couldn’t continue, of course, and I sought to obtain marihuana legally. I couldn’t find enough, and had to keep using pilocarpine. When it started making me see circles again, my doctor was out of town, and I went to a new clinic. When the attending physician there realized that I was using marihuana to treat my glaucoma, he looked very disgusted. He threw two prescriptions at me and sent me home without instructions and warnings. Those two drugs were the most horrible I have ever come across in my life. Diamox took all the potassium out of my body and I was completely apathetic. My children had to care for themselves because when I came home I could only go to bed. At the time I did not have the money to buy the second prescription, phospholine iodide, which I eventually tried and found unbearably painful. I called my hometown newspaper and told a reporter about my use of marihuana in a telephone interview. I spoke without giving my name or picture, because I feared losing my job and custody of my children. But a lot of people recognized the story as mine and came forward, confessing that they were regular marihuana smokers and would help me get marihuana when possible. You can imagine my shock! Some of these people were co-workers, others respected members of the community. None of them-not a one-was a bum as I had been led to think of every marihuana smoker. In January 1977 my doctor sent me to a research center at the University of Miami. He thought they might help me obtain marihuana legally. But the very dedicated scientists at the center didn’t want to hear the “m” word. Instead, I spent one of the most grueling days of my life. When I arrived my pressures were in the high 50s in the right eye and high 40s in the left. They gave me everything they could think of. Drops didn’t help much, nor did using a little pump to flush the eye. I also had to drink a big glass of a sickeningly sweet liquid, which didn’t help either. At the day’s end my pressures had barely lowered to the 40s, so I was scheduled for emergency surgery. At home that night I used a remaining bit of marihuana to bake some brownies, and ate two every twelve hours. The doctors were shocked when they checked my pressures as I arrived for surgery the next Monday morning-perfectly normal at 14 and 16! Regardless, they readied me for surgery, even though it had at best a 30 percent chance of helping me! The following morning they performed an operation on my tear ducts which turned out to be of no value. Because of it I now have to wear the big magnifying glasses that I had managed to avoid since childhood. After this procedure I had less sight, more scar tissue, and higher pressures, and I was unable to return to work. I now faced not only glaucoma but depression and poverty. It would be at least nine months before Social Security could issue a disability check. I was humiliated using food stamps but glad they were available. I developed insomnia. Marihuana was harder to find now that I had no money to buy it. Sometimes compassionate people gave me some and my insomnia disappeared. It was certainly the best antidepressant I have ever come across. By 1980 I had little money and marihuana had gone up in price, so I started growing my own plants. I used the finest seeds, which produced small plants, hard to detect but productive. I only required three or four joints a day. My pressures became so close to normal that my doctors decided a corneal transplant was safe. It worked! I never have had such beautiful eyesight-it was so wonderful! I was so happy, until neighbours jumped the fence around my yard and stole my marihuana plants. My pressures went sky high, and I escaped into alcohol quite a bit of the time. When I started having slight blackouts I realized alcohol was not the answer. So reluctantly and fearfully I went through surgery again. This time I hemorrhaged and before I knew it, my right eye was blind. Since I had only 20/400 vision in my left eye, you could have lit up my bedroom with bright lights as I slept and I wouldn’t have awakened. I was very depressed. Most painful were the happy dreams in which I was seeing out of both eyes and being the person I used to be. Then I would wake up to find myself without the right eye. I needed money and had an extra room in my house, so I put an ad in the paper and acquired a boarder. He assured me he was not taking illegal drugs and would not tell anyone I was growing marihuana. But soon his erratic behaviour convinced me there was a problem, and sure enough, I found cocaine under the bathroom sink. At first he denied using drugs, but a few days later he admitted it. He said he needed cocaine because in his job as a car salesman he was expected to work seven days a week, ten hours a day. I told him that I didn’t care about his reasons he would have to move. He agreed that he would, but as the time grew closer he became reluctant. We argued, and he turned me in to the police. I was arrested on the night of March 4, 1988, and it changed my life forever. I notified the media, and this time my hometown paper photographed me and wrote a full follow-up story. I was contacted by people who had obtained marihuana legally, and my doctor and his secretary spent at least fifty hours on paperwork to be submitted to the DEA, FDA, and NIDA in an effort to secure legal marihuana. I did a lot of radio shows, and it was always heartbreaking because almost always, there was someone who had lost their sight unnecessarily. There were also genuinely concerned citizens who worried about my being addicted to a horrible drug and who sincerely wished that there was another answer for me. Of course, they hadn’t been me and they hadn’t been on it for twelve years, so they didn’t realize that there were no side effects for me to fear. I began to hear from people all over the country, even some from Canada. It was amazing; many were glaucoma patients who had maintained their sight for twenty and twenty-five years with marihuana and are still illegally maintaining it today. I envied them for standing up for their health, for knowing what they were doing and taking care of themselves. But that was no help to me now. I was facing felony charges. In Florida, possession of anything over twenty grams is a felony, and they confiscated an ounce and a half from a plant I had just harvested the previous Monday. My trial began and ended August 15, 1988. I knew one thing: if I was going to court, so was this unjust law. I was not afraid. I felt that God and his angels were with me. I was not mistaken-the only person they could find to testify against me was the arresting officer, and I wouldn’t say he was against me. Glaucoma patients testified on my behalf, and my doctor proclaimed marihuana the only agent that ever provided reliable relief for me. I was asked if I had smoked marihuana since my arrest and I answered yes. “Did you smoke marihuana today?” “Of course,” I replied. The judge listened carefully and decided that for me not to have tried to preserve whatever sight I had left would have been total insanity. He said that I had no intent of criminal activity, and I was acquitted. I had applied for a Compassionate IND in March 1988 and was granted legal use of marihuana provided by the government beginning October 21, 1988. The sight in my right eye is coming back. I now have perceptions of light, colors, and shapes. In my left eye, which used to be 20/400 but is now 20/100, the optic nerve is very healthy and I have lost no peripheral vision. As a matter of fact it has improved. Miraculous-that’s cannabis.”