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Glaucoma Update

A correspondent reminded me over the weekend that I haven't updated my Marinol posting from June, 2013. He wanted to know if my ophthalmologist's idea to dab artificial marijuana over my eyes had continued to reduce my optic nerve pressure and fend off the effects of glaucoma. He said it in terms that no writer likes to hear: "You left the reader hanging."

Thanks for prompting me, Bob. Here's what happened: I continued to use the Marinol -- generic name dronabinol -- which my earlier post explained is artificial THC. It's a capsule that's normally prescribed to increase appetite in AIDS patients. The trans-dermal application worked, but the experiment got sidetracked by a new drug trial.

It started last fall. Ten subjects took eyedrops with rho-kinase inhibitors. Rho-kinase isoforms, or ROCKs, affect cell function and are implicated in hypertension and cardiovascular disease. Rho-kinase inhibitors are prescribed in some of these cases. The inhibitors are thought to reduce intra-ocular hypertension just as they do high blood pressure. At the same time, because of their action on cells, they improve eye drainage, the lack of which is the factor in my particular form of glaucoma.

So I stopped rubbing THC on my forehead and started taking the "ROCK drop" in my right eye as part of what was supposed to be a six-month study. It produced spectacular results: a pressure drop of about 10 points, from the 20s into the teens, in just a week. I and my fellow guinea pigs all saw the improvement.

The big question, though, was whether the effects on drainage last beyond the application. Did the drop cause a permanent relaxation of the mesh that allows the eye to drain?

This was a highly worthy goal. Pseudo-exfoliation syndrome is the kind of glaucoma that I have. It's the leading cause of open-angle glaucoma, which affects 60 to 70 million people around the world including Bono of U2. Just last week, he explained that wears sunglasses all the time because he's had glaucoma for twenty years.

Most eye drops attack the symptom – the pressure on the optic nerve – but not the underlying cause. Many people take these drops for years and maintain healthy eyes. Bono's apparently among them.

But I couldn't take the most effective ones. My eyes itched and watered and turned red. The ones with beta blockers depressed me to the point I couldn’t work or talk. Dr. Robert Ritch, my pioneering ophthalmologist, steered me on a different path including the Marinol experiment.

So I was eager to learn what would happen in the trial. But it never reached that point. Halfway through, Aerie Pharmaceuticals decided to change the formula by adding timolol, a beta blocker, to the ROCK drop. I couldn’t understand it, and neither could the trial doctors. A new trial started but I couldn't take part because it was a blind trial, with half the participants getting only timolol.

It's not all bad news, though. They slipped me a supply of the discontinued drop, which I'm still using. It's kept my pressure in a healthy range. I don’t know what will happen after I run out. Maybe I'll go back on Marinol.

To be continued . . .

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