• Glaucoma

    Review of: Attitudes and perceptions toward the use of medical marijuana by glaucoma specialists

    Bergman Z, Douglas J, Wang J, et al. Journal of Glaucoma, February 2022

    Ophthalmologists specializing in glaucoma were surveyed about their attitudes toward the use of medical marijuana (MMJ) to treat glaucoma.

    Study design

    This was an electronic survey sent to members of the American Glaucoma Society (AGS), all glaucoma-trained providers or glaucoma fellows. Study participants were asked questions regarding their demographic background, knowledge of the efficacy of marijuana in the treatment of glaucoma, prescribing patterns, and experience they have with MMJ use among their patients.

    Outcomes

    In total, 198 AGS members participated, 74% of whom reside in states where MMJ is legal. Forty-four percent of respondents reported having patients who use MMJ to treat their glaucoma, and over half of respondents had patients ask for marijuana prescriptions, regardless of legality in their state. Seventy-six percent of respondents expressed interest in further education about MMJ’s role in the management of glaucoma.

    Limitations

    Only 15% of eligible study participants responded to the survey. Those who responded may have had a stronger interest in the topic than those that did not respond. Survey studies in general are subject to recall bias by respondents.

    Clinical significance

    The official stance of the American Academy of Ophthalmology and the AGS is that MMJ is not an accepted treatment option for glaucoma due to its significant side effects, as well as limited evidence that marijuana slows disease progression. As recreational and medical marijuana use becomes more widely legalized, ophthalmologists should not only be well versed on the available data regarding the utility of MMJ in the treatment of glaucoma, but also have frank communication with their patients regarding the topic. Results from a previous survey, published in 2020, found that while only 7.6% of AGS members recommended marijuana for glaucoma management, 52% of MMJ dispensaries in Colorado endorsed the use of MMJ to treat glaucoma, indicating that many patients may be receiving conflicting information. It is the responsibility of ophthalmologists to provide patients with unbiased, nonjudgmental, and evidence-based recommendations regarding the use of MMJ in glaucoma. In order to do this, most ophthalmologists will need more education on this topic.