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Cannabis and CBD oil: a new “old” friend in optometry

Optometric training requires learning about bones, muscles, neurology, and the vascular and other systems. But have you heard of the endocannabinoid system (ECS)?

If the answer is no, that’s not surprising.

Although the ECS is critical for human survival, 1,2 cannabinoid receptors weren’t identified until 1964, 1-4 when investigators were trying to locate where marijuana tetrahydrocannabinol (THC) interacted with the brain. It wasn’t until 1988 that the ECS was identified, and 1992 when it was officially acknowledged. 2-4

Humans operate on the parasympathetic and sympathetic system. The parasympathetic system operates under “normal” conditions.
When the body perceives it is under attack, neurochemicals trigger the sympathetic system, activating the “fight or flight” response. 5,6

The ECS, simply put, disengages the sympathetic system. It is responsible for bringing the body back into balance (homeostasis). 2,7 If it doesn’t, the body is faced with unresolved “danger” from the chemicals and processes that are designed to protect it. These chemicals cause inflammation and begin attacking and damaging the body, 7,8,9 which is then labeled as “such and such” disease. Our rampant, epidemic health problems are self-inflicted, 5,7,10 brought on by our diet, lifestyle, and technology. 7,10,11

The ECS (Figure 1) is made up of 2 main receptor sites, CB1 and CB2. 2,4,7,10

CB1 sites are primarily in the brain, heart, and lungs, and modulate the immune response. CB2 receptors are primarily located in the lymph system, detoxification organs, and peripheral systems to break down and clear out the toxic immune system chemicals and debris. 1,3,7,14,24

The body produces its own chemical—anandamide, known as the bliss chemical—to regulate our systems via the ECS. 7,13,14 Unfortunately, in today’s high-stress environment, it can’t create enough to keep up with the demand. 10,14

Eating dark chocolate, exercising, or being “in the zone” are other ways to feed the CB1 and CB2 receptors. 7,14 Cannabidiol (CBD) was removed from livestock feed when it was made schedule 1 in 1941, so it has not been in the food chain for 80 years. CBD is nature’s external equivalent to supplementing the body’s anandamide shortage. 17,18,24


Technically, cannabis is not marijuana; nor is CBD. Cannabis is the botanical name for the common hemp plant, which has been cultivated for industrial purposes for more than 20,000 years. 15,18,24

The medicinal properties of hemp have been utilized for over 10,000 years. 15 The 2 main classes of cannabis are sativa, which is generally stimulating, and indica, which is generally calming. 16,18

Marijuana is a small subset of hemp that has been bred to produce more “high.” Hemp has over 400 different chemicals, with 100 compounds known as cannabinoids, each creating various effects. 16,18

CBD is one of the most prevalent cannabinoids in the hemp plant; it has the most profound, diverse, and beneficial impact. 16,18 The main takeaway is that cannabis is really just the hemp plant, and CBD is not marijuana.


THC and CBD originate from the same compound and have nearly identical chemical structures (Figure 2). 16,22 Depending on the genetic strain, the hemp will have higher or lower THC and CBD levels. When the flower is beginning to bloom, however, growers must test the plants daily because the CBD in the plant will start to become THC. 16,22

At that point, the growers only have 48 hours to harvest their crop. The legal amount for THC to not be considered marijuana is 0.3%. 19,22

The CBD industry wants as high an amount of CBD as possible with the least THC possible. CBD’s profound effects on all bodily functions are not forced—unlike those of pharmaceutical agents—and nor does the chemical have their toxicities or unintended adverse effects (Figure 3). 20,21,24

As of February 2022, 37 states in the United States have legalized marijuana for medical use and 18 have legalized it for recreational purposes .20 The medical and recreational marijuana market is projected to be $30 billion in 2022. 21

Although marijuana still has legal hurdles to overcome, the CBD market is legal in all 50 states. 22 CBD is also available OTC and thus is free from FDA regulations and red tape. 22 The CBD market is projected to be $2 billion in 2022. 23

This projection will result in both good and bad consequences. Because cannabis has been outlawed as a Schedule 1 drug for 80 years, little controlled research has been undertaken and no distinction made between the effects of THC and those of CBD.

Medical benefits, risks

Much of marijuana use is for the high it produces, but there are some documented medical benefits. These include the relief of pain and nausea related to cancer treatments, aiding of sleep issues, reduction of posttraumatic stress disorder symptoms, easing of symptoms in those withdrawing from opioid addiction, and a calming of symptoms of various neurological conditions. 4,24

Unfortunately, according to more recent findings, marijuana does interfere with cognitive ability, 24,29 damages memory function, and destroys brain tissue. It also causes heart attacks—even in younger people with no underlying conditions—may have negative effects on genetics and pregnancy, and, if ingested by vaping or smoking, increases cancer risks. 24 Thus, marijuana is far from risk free.

Vision effects

Of more direct concern to optometrists are the negative effects of marijuana on the visual system. Both photopic and scotopic vision are impaired due to decreased macular and peripheral sensitivity. 24-35

Neurologically, vision processing is compromised, creating selective scotomas and interfering with one’s ability to navigate in the environment. 24,26-28,30,32-35

The eye is both a specialized neurologic receptor and a person’s primary connection to the physical world. It is important for optometrists to be aware of CBD, as eyes are packed with both CB1 and CB2 receptors.

Consider the major 5 medical conditions optometrists often encounter with when working with patients:

1. Cataracts 37

2. Glaucoma 38,39

3. Macular degeneration 41-43

4. Allergies 46

5. Meibomian gland disease 47

Although each is a separate condition, all have inflammation as the root cause due to the eye being threatened by the environment. 35,40 Many treatments are based on treating the symptoms or slowing the progression of damage by interfering with the ocular response process.

CBD works with the body’s natural system to decrease the inflammation process and restore homeostasis, avoiding the long-term results that define disease.

Peer-reviewed, evidence-based science is limited. However, I have heard anecdotally that some patients have experienced better vision with OTC supplementation of CBD and ocular nutraceuticals, backed by macular pigment ocular density (MPOD), optical coherence tomography (OCT), retinal photographs, and acuity. 43,44

Looking ahead

We have accepted that ocular “aging” conditions are normal, inevitable, and unstoppable. 45,57 Perhaps traditional medical treatments would be less necessary if we worked with the natural body system designed to minimize those issues.

Beyond ocular conditions, optometrists must step back and look at the larger medical issues facing humanity.

Obesity, diabetes, blood pressure, heart disease, cancer, Alzheimer disease/dementia, autoimmune conditions (lupus), rheumatoid arthritis, fibromyalgia, multiple sclerosis, neurologic disorders, depression, anxiety, panic attacks, migraines, attention-deficit/hyperactivity disorder, and concussions are all inflammation-related processes caused by an increased assault on our physical system.

This has overloaded the natural mechanism eyecare professionals were designed with to maintain health. Optometrists need to learn about ECS and CBD to augment their toolbox for taking care of patients’ well-being. 6,9,36,48,51,55,56,59-63

CBD Oil For Dry Eyes

Cannabis, especially marijuana, is often associated with red eyes in the collective imagination , especially regarding smoking. Marijuana smokers can often be easily identified by the red rings around their eyes, along with characteristics like drowsiness, euphoria, and sometimes excessive hunger also called the munchies. However, people need to understand that THC, not CBD, causes inflamed, watery, and red eyes. But why is that the case? And will CBD ever make your eyes red or dry?

Our cannabis and CBD experts at Care Division are here to explore these essential questions to help you better understand the impacts CBD has on your body. Please continue to learn everything you’ll need to know about the issue, and also consider exploring our selection of other educational CBD resources for even more information. We’re proud to provide people not only with top-quality CBD products but critical knowledge about CBD as a whole.

Why Doesn’t CBD Cause Red or Dry Eyes?

You’ll first want to understand that CBD will not turn your eyes red or dry, no matter how much you smoke, consume, or put on your body, because it doesn’t cause the same effects as THC. They are two different cannabinoids that trigger a diverse range of symptoms in those who smoke or consume them, despite being found in the same plant. To better explain the situation, let’s delve into the primary differences between THC vs. CBD .

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The Basics of THC

THC is the well-known psychoactive component of cannabis that results in a sensation of being “high” or euphoric, but it also causes other symptoms, including red, irritated eyes. This effect occurs because THC dilates blood vessels and lowers blood pressure while ultimately causing the usually small, unnoticeable blood vessels in the eyes to appear more prominent. The higher blood flow in the eyes then triggers excess redness, watering, and irritation, creating the telltale look associated with marijuana smokers. However, the smoke produced from marijuana pipes or joints may also exacerbate eye redness and irritation.

The Basics of CBD

In contrast, CBD is a nonpsychoactive cannabinoid that will not get users high and instead produce a range of other, often beneficial symptoms . CBD is often used to help people relieve pain, relax, and sleep well without altering their mental states. It also doesn’t cause the same effects on blood vessels as THC or cause blood to rush to the eyes. If someone smokes or consumes CBD or CBD-based products, those around them are not likely to notice, as they likely would when someone smokes or consumes THC.

However, please keep in mind that too much of anything can be bad for you, so be sure you don’t go overboard. Just because it’s harder for others to tell if you’ve been smoking or consuming CBD products compared to THC ones doesn’t mean you should go too far. Consider reading our specialized guide on how much CBD is too much and the effects it can cause to learn more.

With so many different CBD products on the market, it can be hard to find the best ones to try first! Care Division can help save you some time by offering access to a wide array of top-quality CBD tinctures, topicals, and beauty products you won’t find anywhere else!

Used CBD and Still Got Red, Dry Eyes? You May Have Been Scammed

If you’ve ever smoked CBD or consumed a CBD product that you thought was THC-free and still ended up with red, irritated eyes, then it wasn’t actually THC-free. Throw the product out right away if you genuinely don’t want to deal with those effects or have THC in your system.

Try using eye drops to relieve the inflammation, and consume things like coffee, chocolate, and salt to help narrow your blood vessels. You’ll generally need to be patient and wait for the issue to resolve itself , but those tactics can sometimes help speed up the process.

You always want to be careful about where you get your products, what brand they belong to, how much they cost, and other critical factors that can help you determine the quality of the product. You’re more likely to encounter this kind of issue if you get your CBD from a friend or an uncertified seller, so always be sure you’re getting your flower and other products from quality, trustworthy sources, like Care Division.

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Migraines are a frustrating condition that impacts your ability to work, study, or rest. Thanks to ongoing medical research, CBD for migraines is becoming a popular tool for pain relief. Recent studies show that at least 15% of Americans struggle with chronic headaches or migraines. While a headache is sometimes caused by dehydration or stress, […]

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