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Glaucoma Studies

Last Reviewed: January 2, 2020

General Facts

Glaucoma more prevailed in cities
Yih-Chung Tham, Xiang Li, Tien Y. Wong, Harry A. Quigley, Tin Aung, Ching-Yu Cheng, “Global Prevalence of Glaucoma and Projections of Glaucoma Burden through 2040: A Systematic Review and Meta-Analysis”, Ophthalmology, Volume 121, Issue 11, 2014,

DNA damage due to oxidative stress is significantly higher in glaucoma patients. Especially in the degenerated areas of the eye that cause glaucoma (trabecular meshwork). The same DNA damage is associated with a higher cancer risk. Glaucoma patients have a higher risk to get cancer.

Alberto Izzotti, Sergio C Saccà, Cristina Cartiglia, Silvio De Flora, “Oxidative deoxyribonucleic acid damage in the eyes of glaucoma patients”, The American Journal of Medicine, Volume 114, Issue 8, 2003,

Oxidative stress in the trabecular meshwork directly correlates with IOP and visual field damage.

Saccà SC, Pascotto A, Camicione P, Capris P, Izzotti A. Oxidative DNA Damage in the Human Trabecular MeshworkClinical Correlation in Patients With Primary Open-Angle Glaucoma. Arch Ophthalmol.2005;

Low anti-oxidant levels overall and oxidative stress in the body was also found to correlate to increased IOP and visual field damange

Association between systemic oxidative stress and visual field damage in open-angle glaucoma, Masaki Tanito, Sachiko Kaidzu, Yasuyuki Takai & Akihiro Ohira, Scientific Reports, PY;

Research identified a correlation between food intake and decreased risk of glaucoma in participants. (Fruits & vegetables high in Vitamin A, C, & carotenoids)

The Association of Consumption of Fruits/Vegetables With Decreased Risk of Glaucoma Among Older African-American Women in the Study of Osteoporotic Fractures, American Journal of Ophthalmology, Volume 154, Issue 4, 2012,

Oxidation of fatty acids correlate with glaucoma. Vitamin E is important to protect the optic nerve fibers.

Engin KN, Yemişci B, Yiğit U, Ağaçhan A, Coşkun C. Variability of serum oxidative stress biomarkers relative to biochemical data and clinical parameters of glaucoma patients.

A study showed that glaucoma patients have increased levels of uric acid which shows that their kidneys don’t work properly.
The right diet can significantly reduce the risk of blindness.

Moïse MM, Benjamin L-M, Doris TM, Dalida KN, Augustin NO. Role of Mediterranean diet, tropical vegetables rich in antioxidants, and sunlight exposure in blindness, cataract and glaucoma among African type 2 diabetics. International Journal of Ophthalmology.

Higher dietary nitrate and green leafy vegetable intake was associated with a lower POAG risk

Kang JH, Willett WC, Rosner BA, Buys E, Wiggs JL, Pasquale LR. Association of Dietary Nitrate Intake With Primary Open-Angle GlaucomaA Prospective Analysis From the Nurses’ Health Study and Health Professionals Follow-up Study. JAMA Ophthalmol.

Research suggest that vitamin D deficiency should be considered as a potential risk factor for the development of OAG

Yoo, T., Oh, E., & Hong, S. (2014). Is vitamin D status associated with open-angle glaucoma? A cross-sectional study from South Korea. Public Health Nutrition,

In elderly patients, Glaucoma is a significant predictor of Alzheimer.
There is a close link between glaucoma and Alzheimer’s disease.

Andreas U Bayer, Othmar N Keller, Francis Ferrari, Klaus-Peter Maag,
Association of glaucoma with neurodegenerative diseases with apoptotic cell death: Alzheimer’s disease and Parkinson’s disease, American Journal of Ophthalmology, Volume 133, Issue 1, 2002,

Glaucoma patients even show an increased amount of biomarkers for Alzheimer in the aqueous humor.

Toshihiro Inoue, Takahiro Kawaji, Hidenobu Tanihara; Elevated Levels of Multiple Biomarkers of Alzheimer's Disease in the Aqueous Humor of Eyes With Open-Angle Glaucoma. Invest. Ophthalmol. Vis. Sci. 2013;54(8):5353-5358. doi: 10.1167/iovs.13-12245.

Glaucoma & Alzheimer’s have the same oxidative stress damage.

Trovato Salinaro Angela, Cornelius Carolin, Koverech Guido, Koverech Angela, Scuto Maria, Lodato Francesca, Fronte Vincenzo, Muccilli Vera, Reibaldi Michele, Longo Antonio, Uva Maurizio G., Calabrese Vittorio; Cellular stress response, redox status, and vitagenes in glaucoma: a systemic oxidant disorder linked to Alzheimer’s disease; Frontiers in Pharmacology; 5/2014

The degeneration of the eye and in Alzheimer’s are very similar and overlapping. Especially in the areas of neuroinflammation, and oxidative damage.

Jeremy M. Sivak; The Aging Eye: Common Degenerative Mechanisms Between the Alzheimer's Brain and Retinal Disease. Invest. Ophthalmol. Vis. Sci. 2013;

Vanderbilt University reports that researchers in the Vanderbilt Eye Institute discovered that glaucoma first starts in the brain.
First signs of glaucoma found in brain

Distal axonopathy with structural persistence in glaucomatous neurodegeneration; Samuel D. Crish, Rebecca M. Sappington, Denise M. Inman, Philip J. Horner, David J. Calkins; Proceedings of the National Academy of Sciences Mar 2010,

Glaucoma seems to be a systematic health issue, including sleeping problems, blood pressure, headaches, migraine, thyroid issues, and Autonomic nervous system, so breathing, digestion, and your heart functions.

Pache, Mona, and Josef Flammer. “A Sick Eye in a Sick Body? Systemic Findings in Patients with Primary Open-Angle Glaucoma.” Survey of Ophthalmology 51.3 (2006):

Endocannabinoid System regulates Blood Pressure - CBD good for hypertension (high blood pressure):
Blood pressure regulation by endocannabinoids and their receptors
Eye Drops target a 20% eye pressure reduction from the Baseline eye pressure value:
What is the target pressure?

Joann A. Giaconi, Fei Yu, Katie L. Stone, Kathryn L. Pedula, Kristine E. Ensrud, Jane A. Cauley, Marc C. Hochberg, Anne L. Coleman,
Yuki, K., Murat, D., Kimura, I. et al. Graefes Arch Clin Exp Ophthalmol (2010).

Article Source: Glaucoma, Alzheimer's Disease, and Parkinson's Disease: An 8-Year Population-Based Follow-Up Study Lin IC, Wang YH, Wang TJ, Wang IJ, Shen YD, et al. (2014) Glaucoma, Alzheimer's Disease, and Parkinson's Disease: An 8-Year Population-Based Follow-Up Study. PLOS ONE 9(10): e108938.

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Does Cannabis Cure Glaucoma

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  • Cannabinoids effectively lower the intraocular pressure (IOP) and have neuroprotective actions
  • How CBD works vs THC:
  • Researched since 1971
  • 25–30% IOP lowering effect
  • Works 3-4 hrs
  • Reduction of systemic blood pressure
  • Unilateral topical application of cannabinoids 34,35 showed a large difference between the treated and untreated eye, suggesting a localized action
  • Neuroprotective properties of cannabinoids
  • CBD have antioxidant properties that are not mediated by the CB1 receptor. As a result, they can prevent neuronal death by scavenging toxic reactive oxygen species produced by overstimulation of receptors for the excitatory neurotransmitter, glutamic acid.7,16–18,64
  • Cannabinoids have vasorelaxant properties and so might be able to increase the ocular blood flow.
  • Tolerance doesn’t develop after repeated use of cannabinoids. 30
  • Oral administration has been evaluated. However, there is a poor and variable absorption with this route,33 at least for the cannabinoid formulations that have been investigated so far.
  • Unilateral topical application of cannabinoids34,35 showed a large difference between the treated and untreated eye, suggesting a localized action
  • Straiker et al 11 detected CB1 receptors in ocular tissues of the human eye, including the ciliary epithelium, the trabecular meshwork,
  • Anatomical distribution of cannabinoid receptors suggests a possible influence of endogenous cannabinoids on trabecular and uveoscleral aqueous humour outflow and on aqueous humour production
  • Ingestion, while considered by most to be the easiest administration method, isn’t the most efficient for absorbing high levels of CBD. Studies have found, however, that consuming CBD oil with fatty acids can help bypass first pass metabolism and increase how much CBD is absorbed through ingestion.
  • If CBD oil is held under the tongue for 60 to 90 seconds before being swallowed, the mucus membranes in the mouth can absorb the compounds. This sublingual method allows CBD to completely bypass the digestive system and liver metabolism, so the compounds can avoid being broken down by enzymes and reach the bloodstream more quickly.
  • Consuming CBD oil with fatty acids can help bypass first pass metabolism and increase how much CBD is absorbed through ingestion.
  • If CBD oil is held under the tongue for 60 to 90 seconds before being swallowed, the mucus membranes in the mouth can absorb the compounds. This sublingual method allows CBD to completely bypass the digestive system and liver metabolism, so the compounds can avoid being broken down by enzymes and reach the bloodstream more quickly.
  • Besides the natural health benefits of CBD, hemp oil topicals also contain an array of other essential nutrients, including vitamins, minerals, proteins, and fatty acids, to encourage skin health. Vitamins A and D are responsible for skin repair. They support skin cell growth and inhibit oil production to help keep skin soft and supple. Like CBD, Vitamins C and E are antioxidants and protect the skin’s collagen and elastin against damage from the sun and free radicals. B complex vitamins serve as part of the construction process for skin, hair and nails to prevent dermatitis, hair loss, and other skin conditions.
  • Topicals are applied right to trouble areas so that the CBD oil can work directly where it’s needed most. Ingesting CBD products orally causes CBD and other compounds to enter the bloodstream, which elicits full-body effects and takes up to 2 hours or more before those effects are experienced.
  • When CBD oil is applied topically, or directly to the skin, it never reaches the bloodstream but can be absorbed through the skin’s surface to interact with nearby cannabinoid receptors.
  • Straiker et al11 detected CB1 receptors in ocular tissues of the human eye, including the ciliary epithelium, the trabecular meshwork, Schlemm’s canal, ciliary muscle, ciliary body vessels, and retina.
    (Straiker A, Maguire C, Makie K, et al. Localization of cannabinoid CB1 receptors in the human anterior eye and retina. Invest Ophthalmol Visual Sci 1999;40:2442–8. Abstract/FREE Full Text)
  • The endocannabinoid system(ECS), which is often described as a major regulatory system
  • ECS is responsible for the side effects (good and bad)
  • Two cannabinoid receptors to know about are CB1 and CB2
  • The ECS regulates:
  • The human eye and rats’ eyes have a similar distribution of CB1 and CB2 receptor cells in the eye
  • CBD does not directly interact with CB1 & CB2 receptors.  Instead, it affects signaling through CB1 and CB2 receptors indirectly
  • Increase levels of the body’s own naturally-produced cannabinoids (known as endocannabinoids) by inhibiting the enzymes that break them down.
  • CBD’s ability to influence either opioid or dopamine receptors
  • CBD-derived pharmaceutical drug was just approved by the FDA for seizure disorders, and THC-based drugs
  • In 2004, a US patent was granted to Allergan Inc, which claims the use of abn-cbd as a novel anti-glaucoma agent to lower intraocular pressure (US 7,618,966). In addition, a recent publication has documented the IOP-lowering effects of abn-cbd (Szczesniak et al., 2011).
  • Even though Low-dose cannabinoids temporarily decrease intraocular pressure (SOR: C, disease-oriented outcome). However, a consensus opinion guideline from the American Glaucoma Society recommends against its use (SOR: C, consensus opinion).
  • THC & CDB together are more powerful - entourage effect:
  • "I have been using CBD on various patients at my functional medicine center for some time now, and we are loving the clinical results! I use it to support healthy balanced inflammation levels in people with autoimmunity, pain, and anxiety. For some, CBD has truly been the missing link in their health puzzle. It's one of the few things that I, too, take every day." William Cole, D.C.
  • "Ultimately there is a role for CBD in a variety of conditions. It decreases anxiety, is anti-inflammatory, and can help with sleep. It does also have some positive impact on pain. Some of it may be for the reasons I listed above. It doesn’t have the psychotropic effects of THC, and it is legal (for now). The tricky part is that we don’t have robust studies fully clarifying dose, interactions, and contraindications. I do have patients who anecdotally find that it is helpful when used topically for arthritis and orally (spray) for pain. I think often it is beneficial because it helps with sleep and anxiety, which both can be an issue with both acute and chronic pain. I have other patients who have no response."Carrie Diulus, M.D.
  • "CBD varies per concentration, so getting a reliable brand and source is key. It doesn’t alter the person's state of mind who uses it like marijuana does, but it does produce many positive changes and has many medical benefits including improving the immune system, being anti-inflammatory, improving mood, appetite, cognitive function, anxiety, depression, insomnia, addiction, epilepsy, improves cancer, Crohn's disease, and even acne. Physicians recommend it for their chronic pain patients as well as fibromyalgia and multiple sclerosis. Studies have shown the use of CBD oil in mice reducing inflammation significantly. Physicians also recommend CBD oil in patients who want to quit smoking as well as decrease opioid usage. It seems to be the wonder drug everyone wants! You can inhale it, rub in on the skin, or put drops in your food. My personal reservations for CBD oil are there are still no long-term safety data studies and studies haven’t been done in children yet. Some side effects include diarrhea and weight and appetite changes. Talk to your doctor if this is a good alternative and to see if CBD is right for you." —Bindiya Gandhi
  • The University of Natural Medicine reports that glaucoma directly correlates with oxidative stress. Oxidative stress happens when an intense inflammatory response is stimulated to relieve damage (i.e., injury, infection) through microglial and macrophage discharge. This discharge correlates with the release of glutamate, reactive oxidative species (ROS), nitric oxide (NO), and tumor necrosis factor (TNF); a release that would intensify inflammation, vascular decay and biodegradation. These are all remnants of metabolic syndromes; ocular health is affected profoundly by metabolic diseases. Age-related cataracts, glaucoma, maculopathy and diabetic retinopathy become more likely to occur if combined with metabolic syndrome.
    Therefore phytocannabinoids are already proposed for the prevention of several ocular disorders. CBD studies have found it a suitable candidate for hindering oxidative stress response that is activated by microglial cells and thereby decreasing any damages that might result from inflammatory response.
  • Studies have shown that when the retinal ganglion cells release excessive amounts of glutamate (an essential neurotransmitter), ischemia-related neurotoxicity and cell death arise. In this case, CBD already reduces the production of ROS or reactive oxygen species and therefore is a promising non-inebriating antioxidant. In these studies, CBD is suitable for protection from retinal injuries induced by glutamate; it prevents the formation of compounds essential for the development of glaucomas such as lipid peroxides, nitrite, nitrate, and nitrotyrosine.5, 7
  • The University of Natural Medicine reports that, “CBD can be a further used to prevent the apoptosis and retinal ganglion cell death, which are the two leading pathways to visual loss. Current studies propose CBD’s neuroprotective properties as a suitable glaucoma treatment. Periodic doses of administered CBD reduce the intraocular pressure, which in turns would hinder the development of neurodegenerative and apoptotic processes.  The therapeutic applications of CBD for glaucoma treatment is well documented.5, 6, 13”
  • The retina is inclusive of the endocannabinoid system, where research has shown the effectiveness of CBD in the reduction of oxidative and nitrative stress. The properties of CBD that are effective in diabetes treatment such as anti-inflammatory, neuroprotective, are also essential for the prevention of diabetic retinopathy.1, 2, 4, 9, 11, 12
Does Cannabis Cure Glaucoma

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Does Cannabis Cure Glaucoma

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A statistically significant decrease in the mean IOP was observed at 2 weeks

Higher fruit & vegetable intake = less glaucoma

  • Anne L. Coleman, Katie L. Stone, Gergana Kodjebacheva, Fei Yu, Kathryn L. Pedula, Kris E. Ensrud, Jane A. Cauley, Marc C. Hochberg, Fotis Topouzis, Federico Badala, Carol M. Mangione,
  • Glaucoma Risk and the Consumption of Fruits and Vegetables Among Older Women in the Study of Osteoporotic Fractures,
  • American Journal of Ophthalmology, 2008,

Important nutrients: Vitmins A, C, E, lutein, zeaxanthin

  • Joann A. Giaconi, Fei Yu, Katie L. Stone, Kathryn L. Pedula, Kristine E. Ensrud, Jane A. Cauley, Marc C. Hochberg, Anne L. Coleman,
  • The Association of Consumption of Fruits/Vegetables With Decreased Risk of Glaucoma Among Older African-American Women in the Study of Osteoporotic Fractures,
  • American Journal of Ophthalmology, 2012,

Too much Calcium and Iron from supplements increases the risk of glaucoma

High levels of Vitamin C beneficial for glaucoma patients

Oxidative Stress plays an important role in the development of glaucoma

  • Mozaffarieh, M., M.C. Grieshaber, S. Orgül, and J. Flammer. “The Potential Value of Natural Antioxidative Treatment in Glaucoma.” Survey of Ophthalmology 53, no. 5 (2008): 479–505. doi:10.1016/J.SURVOPHTHAL.2008.06.006.

Anthocyanins & Bilberry important to fight oxidative stress

  • Mozaffarieh, Maneli, and Josef Flammer. “Is There More to Glaucoma Treatment Than Lowering IOP?” Survey of Ophthalmology 52 (2007): S174–S179. doi:10.1016/J.SURVOPHTHAL.2007.08.013.

Vitamin B12 deficiency

Higher intake of riboflavin and niacin were related to a lower risk of glaucoma. Overall, lower intake of niacin remained significantly associated with glaucoma also in the subgroup analysis.

Bilberry extracts contain high quantities of anthocyanin, a flavonoid with antioxidant properties.

  • Parikh RS, Parikh SR. Alternative therapy in glaucoma management: Is there any role? Indian Journal of Ophthalmology. 2011;59(Suppl1):S158-S160. doi:10.4103/0301-4738.73679.

Lack of oxygen in the eye contributes to glaucoma

  • Konieczka, K., S. Fränkl, M. Todorova, and P. Henrich. “Unstable Oxygen Supply and Glaucoma.” Klinische Monatsblätter Für Augenheilkunde 231, no. 02 (2014): 121–26. doi:10.1055/S-0033-1360242.
Recent study in the Journal “Current Neuropharmacology” concluded that some nutrients have proven capable of lowering IOP, increase circulation to the optic nerve, modulate excitotoxicity and promote RGC survival.
Some studies show that nutrients help with that indirectly. Meaning, they affect some bodily systems indirectly to achieve that.
  • Cutatuib
The Rotterdam study showed a direct link between lack of essential nutrients and the risk and occurence of glaucoma.
The study concluded that the nutrients in our supplement have a protective effect on glaucoma patients.
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Pure Vision Method

  • Abnormalities in blood pressure and blood flow play a central role in glaucoma
  • Chronic high blood pressure = bad for glaucoma = vision loss (ganglion cells die)
    • important to avoid over- & under treatment of blood pressure
    • needs to be balanced
    • He, Z. , Vingrys, A. J., Armitage, J. A. and Bui, B. V. (2011), The role of blood pressure in glaucoma. Clinical and Experimental Optometry, 94: 133-149. doi:10.1111/j.1444-0938.2010.00564.x
  • Glaucoma is a hormonal issue - Women early Menopause
    • Caroline A. A. Hulsman, Iris C. D. Westendorp, Raan S. Ramrattan, Roger C. W. Wolfs, Jacqueline C. M. Witteman, Johannes R. Vingerling, Albert Hofman, Paulus T. V. M. de Jong; Is Open-Angle Glaucoma Associated with Early Menopause? : The Rotterdam Study, American Journal of Epidemiology, Volume 154, Issue 2, 15 July 2001, Pages 138–144,
  • Glaucoma patients have a high degree of anxiety and depression. Eye drops didn’t cause the depression.
    • High Prevalence of Anxiety and Depression in Patients With Primary Open-angle Glaucoma; Mabuchi, Fumihiko MD, PhD*; Yoshimura, Kimio MD, PhD†; Kashiwagi, Kenji MD, PhD*; Shioe, Kunihiko MD, PhD‡; Yamagata, Zentaro MD, PhD§; Kanba, Shigenobu MD, PhD∥; Iijima, Hiroyuki MD, PhD*; Tsukahara, Shigeo MD, PhD; Journal of Glaucoma: October-November 2008 - Volume 17 - Issue 7
    • Anxiety, Depression, and Quality of Life in Turkish Patients with Glaucoma; Sevinc Tastan, Emine Iyigun, Atilla Bayer, and Cengizhan Acikel; Psychological Reports; Vol 106, Issue 2
  • Treat eye pressure is not enough:

Glaucoma Surgery Risks

Patients undergoing glaucoma surgery are at increased risk for the development and progression of cataract.

  • Camille Hylton, Nathan Congdon, David Friedman, John Kempen, Harry Quigley, Eric Bass, Henry Jampel, Cataract after glaucoma filtration surgery, American Journal of Ophthalmology, Volume 135, Issue 2, 2003,
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