Effect of sublingual application of cannabinoids on intraocular pressure: A pilot study

Ileana Tomida, Augusto Azuara-Blanco, Heather House, Maggie Flint, Roger Guy Pertwee, Philip J. Robson

Research output: Contribution to journalArticle

109 Citations (Scopus)


Purpose: The purpose of this study was to assess the effect on intraocular pressure (IOP) and the safety and tolerability of oromucosal administration of a low dose of delta-9-tetra-hydrocannabinol (Delta-9-THC) and cannabidiol (CBD).
Patients and Methods: A randomized, double-masked, placebo-controlled, 4 way crossover study was conducted at a single center, using cannabis-based medicinal extract of Delta-9-THC and CBD. Six patients with ocular hypertension or early primary open angle glaucoma received a single sublingual dose at 8 AM Of 5mg Delta-9-THC, 20mg CBD, 40mg CBD, or placebo. Main outcome measure was IOP. Secondary outcomes included visual acuity, vital signs, and psychotropic effects.
Results: Two hours after sublingual administration of 5mg Delta-9-THC, the IOP was significantly lower than after placebo (23.5 mm Hg vs. 27.3 mm Hg, P = 0.026). The IOP returned to baseline level after the 4-hour IOP measurement. CBD administration did not reduce the IOP at any time. However, the higher dose of CBD (40 mg) produced a transient elevation of IOP at 4 hours after administration, from 23.2 to 25.9 mm Hg (P = 0.028). Vital signs and visual acuity were not significantly changed. One patient experienced a transient and mild paniclike reaction after Delta-9-THC administration.
Conclusions: A single 5 mg sublingual dose of Delta-9-THC reduced the IOP temporarily and was well tolerated by most patients. Sublingual administration of 20 mg CBD did not reduce IOP, whereas 40mg CBD produced a transient increase IOP rise.

Original languageEnglish
Pages (from-to)349-353
Number of pages5
JournalJournal of Glaucoma
Issue number5
Publication statusPublished - Oct 2006


  • delta-9-tetrahydrocannabinol
  • cannabidiol
  • glaucoma
  • IOP
  • ocular toxicity
  • messenger RNA
  • receptor CB1
  • Delta-9-tetrahydrocannabinol
  • neurotoxicity
  • involvement
  • injury
  • eye


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