Glaucoma affects around 60 million people in the world and is the leading cause of permanent blindness. Could cannabis be the cure or is the risk greater than the reward?
We note that the subject contained in this article represents illegal activity in certain jurisdictions. Whilst we do not condone any acts which are contrary to any such laws, we understand that readers in those jurisdictions which have decriminalised cannabis may find this article of interest.
Since the 1930s cannabis culture has evolved from 'Reefer Madness' into a medicinal marvel. It's gained traction in the wellness sector and gained popularity amongst icons like Martha Stewart, Mike Tyson, and Whoopi Goldberg. Now, we know that cannabis can ease symptoms relating to Alzheimer's, Crohn's disease, and glaucoma.
The role of the endocannabinoid system (ECS) has become well-known in the medical community since its discovery in the 1980s. While research and development into cannabinoids have not yet piqued, its popularity with easing pain, spasms, and mood has soared.
As cannabis still classifies as a Schedule I drug under federal law, cannabis use, research, and development remain restrictive. Clinical research is developing, albeit, at a slower pace than the demand for it; and clinical evidence remains mixed despite its widely known anecdotal praise.
Glaucoma is a qualifying condition in 30 out of the 33 U.S. states where medical marijuana is legal. It reduces blood pressure levels and serves as a neuro-protectant all while easing the pain. It's a fact that cannabis can help glaucoma patients.
So, what's the issue?
What is Glaucoma?
Glaucoma is a condition in which high blood pressure in the eyeball creates damage to the optic nerve. If untreated it can lead to permanent blindness. Symptoms of glaucoma include loss of sight, seeing aura-like effects, and blurred vision. It also can cause severe headaches and eye pain with nausea and vomiting. Research into treating glaucoma has excelled in recent decades, however, treatment remains restricted to eye drops and laser eye surgery.
While the direct cause of glaucoma remains a mystery, it's known as a progressive complication in diabetes patients and is also linked with the onset of Alzheimer's. It's a degenerative condition, making any damage caused irreversible.
Glaucoma is incredibly hard to self-detect, early signs of vision loss are almost impossible to notice. Though the beginning stages of glaucoma commonly occurs later in life, the condition can occur at any age.
So, if you are showing glaucoma-related symptoms or are related to someone who has the condition, speak to your physician. Early detection is the key to its management and is the best way to prevent complications.
How Does Cannabis Help Glaucoma?
The ECS is responsible for our daily functions. It can aid inflammation, protect the nerves, reduces pain perception, and even stops pain signals from reaching the brain. It plays a vital role in our physiological wellbeing and can alleviate an amalgamation of symptoms from multiple conditions.
Glaucoma is progressive and is dependent on the damage to the optic nerve. This is caused from high intraocular pressure levels (IOP: high blood pressure in the eye). This causes severe pain and can eventually lead the patient to lose their sight.
Cannabis serves as a natural stimulant of the ECS through the plant's cannabinoids. Cannabinoids like THC and CBD activate the CB1 and CB2 receptors, encouraging the ECS to work and alleviate physiologically-related symptoms. Cannabis can alleviate eye pain, reduce blood pressure, and lower IOP levels while protecting retinal cells.
There's one catch: cannabis can also worsen the condition over time.
Can cannabis harm glaucoma patients?
In the 1970s, scientists discovered that consuming cannabis reduced IOP levels by 25%; making it an efficient treatment option for patients. Another study in 1980 found that THC can lower IOP as well as reducing blood pressure. In 2006, another study found that the sublingual (under the tongue) administration of THC briefly lowered IOP levels.
Weed can also, however, lead to unstable IOP, putting patients at a heightened risk of losing their sight. Because THC reduces blood pressure, it can also deprive the optic nerve of a healthy supply of blood. Over time the deprivation of blood supply can increase damage to the optic nerve. This is why physicians are reluctant to prescribe cannabis to their patients in the early stages of glaucoma.
Instead, physicians are more likely to suggest cannabis with patients in the later stages of the condition. In more advanced cases, treatment has usually transitioned from targeting the progression of glaucoma to managing and relieving its symptoms.
To complicate matters even further, consuming cannabis only produces short-term relief. Patients would need to smoke weed up to six to eight times a day to reach desirable levels of IOP.
This approach is not viable. No matter how much weed can help, no good can come from being high 24 hours a day.
Is Cannabis Treatment Effective?
Even though it works, the administration of cannabis remains an issue. Smoking cannabis does not give lasting effects and oral administration can remain unpredictable. While using cannabis orally can be a safer option, the side effects of THC can pose further problems for patients. Depending on the patient, THC can also cause paranoia, increased heart rate, and impaired cognitive processing.
Cannabis eye-drops can be difficult as well. Because THC isn't water-soluble, it's difficult to have enough THC concentrates for it to take effect.
Interestingly, in Glaucoma patients, CBD doesn't have the desired effect one would expect either. In fact, studies have found that CBD might increase IOP levels. While THC appears to have the answers, until an effective treatment is developed, its benefits are restricted to a select demographic.
Until then, there have been anecdotal cases in which cannabis has successfully alleviated symptoms. In any case, more research is needed to make sure that medicinal cannabis does not worsen glaucoma.
Cannabis has unique effects on everyone. It can be used as a short-term treatment option for patients in conjunction with existing medications. However, Cannabis can react with existing medications. Patients need to have an open dialogue with their physician to see if this is a potential option.
If you have glaucoma and are considering cannabis, please speak with your health-care professional to discuss whether cannabis can be incorporated into your existing treatment plan.
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