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Guide to Cannabis and Glaucoma

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States such as Arkansas have listed glaucoma as one of the qualifying conditions for medical cannabis treatment. In fact, some glaucoma patients have been receiving medical cannabis treatment under the federal government compassionate program from as early as 1972. Research has shown that cannabis reduces intraocular pressure which significantly contributes to the development and progression of glaucoma. However, there is no proof that medical cannabis cures glaucoma.

Glaucoma is a disease that affects the optic nerve in the eye, which is the cable that makes the connection between the eye and the brain. Glaucoma has been known to cause progressive vision loss that even results in blindness in some cases.  A key feature of glaucoma is high pressure experienced inside the eye.

Recently, research has been carried out that has shown the promise of cannabis in relieving symptoms of glaucoma. Though the research has been limited, it is still worth discussing. Join as we explore the pros and cons of using cannabis in glaucoma treatment.

Traditional Treatments for Glaucoma

Though many forms of treatment for glaucoma exist, the most widely used is aimed at lowering the intraocular pressure (IOP). This largely helps preserve visual function by either slowing or halting the progressive damage happening to the optic nerve. Traditional treatments for glaucoma can be divided into three categories: laser treatment, use of medications, and surgery.

The most commonly used of these methods of conventional medicine is the eye drops that contain prostaglandins, beta-blockers, and cholinergic agents among others. Though there are some that are quite effective in lowering IOP, most of them have long lasting side effects. In addition, the effect of these drops tends to decrease over time and one is required to use more medicine progressively.

Some people still do not tolerate daily eye drops particularly well while others prefer to avoid surgery and instead seek for alternative natural therapies. This is where therapies such as cannabis come in.

What are the Treatment Alternatives for Glaucoma?

For those seeking to treat or manage their glaucoma with alternative methods, a number of options exist. We will mention a few.

Sleeping Position: According to some studies, lying down increases IOP while being upright reduces it. Sleeping at a 30 degree incline could reduce IOP by up to 20%.

Use of Melatonin: Melatonin is a hormone that is mostly associated with sleep. Some studies have shown that it can reduce intraocular pressure. Though somewhat effective with an IOP reduction of between 19-28%, melatonin supplementation has a host of side effects.

Acupuncture: This is a tricky one that may cause more harm than good! Some people recommend it though.

Omega 3 Essential Fatty Acid Supplementation: Because of its positive effects on vascular health, omega 3 is thought to benefit the health of the optic nerve, reducing damage that worsens glaucoma.

Antioxidants: Combating free radicals from oxidative stress may be beneficial in the treatment of glaucoma. Polyphenol compounds which include resveratrol are key in this.  Other antioxidants are turmeric, coenzyme Q10, dark chocolate, ginkgo biloba and green tea.

Is Cannabis Effective in Treating Glaucoma?

Not many studies have been carried out to investigate the safety and efficacy of using cannabinoids to treat glaucoma. However, preliminary evidence suggests that the psychoactive cannabinoid in cannabis, aka THC, can lower intraocular pressure and hence relieve symptoms of glaucoma.  Another cannabinoid CBD may have action on receptors in the eye thereby offering protection against any damage to the optic nerve (neuroprotection).  This provides a different kind of treatment for glaucoma and is worth further studies.

The main action of cannabis in lowering eye pressure sometimes also results in lowered blood pressure which would reduce blood flow to the optic nerve. It is therefore important to monitor use to prevent any adverse effects.

How to Consume Cannabis for Glaucoma

When choosing a method to consume cannabis you need to ask yourself two questions.

  • Is this method effective?
  • Is this method suitable for me?

While eye drops would be the most natural choice for applying the treatment, THC happens not to be very water-soluble. Resultantly, it has been challenging to develop a THC eye drop that has high enough concentrations for it to be effective.

Smoking or vaporizing cannabis may provide instant relief but the effects may not last for a long time. The patient may then be forced to smoke 6-8 cannabis joints in a day. Oral formulations of cannabis are a preferred consumption method for addressing glaucoma symptoms. Tinctures that are ingested sublingually are convenient and deliver effects quickly. Capsules and gummies are discrete and simple to use for glaucoma treatment.

Challenges in Using Cannabis for The Treatment of Glaucoma

Though effective in lowering eye pressure, the effects of cannabis typically only last between 3 and 4 hours. This means that in order for it to be effective, multiple doses would be required.

Also, the mood-altering effects of THC would make tasks such as driving and operating heavy machinery challenging. The same applies for jobs that require high levels of mental engagement.

Furthermore, consuming cannabis via smoking could have a negative effect on the lungs or even the brain in cases of long term use.

Final Note

The full extent of the therapeutic potential of cannabis is yet to be realized. When it comes to glaucoma the research evidence is suggestive of potential benefits due to the ability of THC to lower intraocular pressure. This is good news for patients who typically do not tolerate conventional glaucoma treatments well as they can turn to cannabis for the effective lowering of their eye pressure.

References:

  1.   The Use of Marijuana to Treat Glaucoma. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6181747/
  2.   NIH National Eye Institute. Glaucoma. Rapino C, Tortolani D, Scipioni L, Maccarrone M. Neuroprotection by (endo) cannabinoids in glaucoma and retinal neurodegenerative diseases . Curr Neuropharmacol. 2018;16(7):959-970. doi:10.2174/1570159X15666170724104305
  3.   American Academy of Ophthalmology. Does marijuana help treat glaucoma or other eye conditions?
  4.   Volkow ND, Baler RD, Compton WM, Weiss SR. Adverse health effects of marijuana use. N Engl J Med. 2014;370(23):2219-27. doi:10.1056/NEJMra1402309
  5.   Glaucoma Research Foundation. Does blood pressure affect glaucoma?
  6.   Mastereyeassociates: Alternative Glaucoma Treatments. Retrieved from https://www.mastereyeassociates.com/glaucoma-alternative-treatments

 

 

 

 


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