Abstract:
Support for legalizing marijuana use and not simply for medical purposes has been rising
steadily since the early 1990s. Currently there are 18 states with medical marijuana privileges
and in 2012, 2 of those 18 states legalized marijuana for recreational use. What does this mean
for Optometrists as more and more of our patients are using marijuana leisurely. This lecture
will address marijuana’s pharmaceutical and ocular effects, how it affects the anterior segment
as well as the posterior segment of the eye.
Outline:
1. History of marijuana in the USA
o Recent news about marijuana in the USA, especially after 2012 presidential
election – pertaining to specific states
o States that legalize marijuana as a medical remedy (18 different states)
o States that legalize marijuana for recreational use (WA and CO)
o Medical marijuana privileges vs recreational marijuana use: what does it mean,
when does it come into effect
2. Pharmacology of marijuana
o Reasons for medical use (ie: marijuana for legitimate pain management in
terminal cancer patients)
o Reasons for ophthalmic use (ie: treatment of glaucoma)
o Dosage amount to see an effect
o How much is too much
3. Examining a patient who uses marijuana
o What to ask during case history
 How much are they taking
 How long have they been taking
 When did they last take it
o What to look during evaluation
 External
 Pupils – dilated
o How does that affect examination (measure pupils during
light and dark illumination)
o How does it affect refractive surgery
o How does it affect aberration and vision changes
o How does it affect focusing
 Anterior Segment
 IOP
o How does it affect IOP measurement
o Does it contribute to angle closure glaucoma?

Ocular surface
o How does it look on slit lamp
o Dry eyes, red eyes
o How does it affect your treatment methods
 Posterior Segment
 Optic nerve
o How does it affect the optic nerve
4. Overview of recent research studies about marijuana
5. Potential “Ophthalmic benefits” of other comparable drugs
o For example, use of topical cocaine to confirm the diagnosis of Horner's
Syndrome
o How does those drugs affect pupils, IOP, anterior segment and posterior
segment
6. Marijuana and children
o What parents should know