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Glaucoma and Cannabis by Peter Kershaw , contributing writer
Glaucoma was among the very first diseases for which it was argued that a legal exception should be granted for the compassionate medicinal use of cannabis . The first of such studies was conducted in 1971 , with several similar studies conducted in quick succession , confirming the original results . At the time , these studies created quite a buzz , and the buzz continues ( to varying degrees ) to this day . Readers of this author know I ’ m a strong proponent of the medicinal benefits of cannabis , of which there are many , including that it ’ s not only much safer but also often as or more effective than pharmaceuticals . I ’ m sad to say , though , as it applies to glaucoma , any said benefits are overblown because they are simply too impractical to achieve on a daily basis .
Glaucoma is a category of eye conditions that result in damage to the optic nerve . Left untreated , it can result in blindness . Over three million Americans are living with glaucoma . Though glaucoma is far less common in the young and far more often afflicting the elderly , it can still occur at any age . Glaucoma is one of the leading causes of blindness for people over the age of 60 .
High pressure in the eye , known as intraocular pressure ( IOP ), is the leading cause of glaucoma . The eye continually makes what is known as “ aqueous humor .” As new aqueous flows into the eye , the same amount needs to drain out . This process keeps pressure in the eye ( IOP ) at a proper level . If this drainage process isn ’ t functioning properly , excess fluid accumulates , resulting in higher than normal IOP . Excessive IOP can damage the optic nerve . If recognized early and treated , vision loss may be prevented , or at least slowed .
Unfortunately , some forms of glaucoma may have no obvious warning signs . The onset and progression can be gradual enough that , if one isn ’ t paying attention , one may not notice a significant change in vision until some degree of damage has been done . Left untreated , it can lead to blindness . The most common form of glaucoma is “ open-angle glaucoma .” But there are several others , as well , including “ acute angle-closure glaucoma ,” which should be treated as a medical emergency . Eye doctors have a quick and easy test for IOP , so it ’ s a good idea to have your eyes checked annually , especially for the elderly .
Treatments
The most common glaucoma treatment is eye drops , typically applied once a day . They work by either promoting drainage , reducing fluid production , or combining both mechanisms . Depending on the patient , one type of drop may be more effective and better tolerated than the others . As such , some experimentation may be appropriate . Glaucoma eye drops are not a cure and must be taken consistently and daily throughout one ’ s life . They are often quite effective . Unfortunately , it ’ s not unusual that patients may experience uncomfortable side effects with one particular kind of eye drop , possibly including eye irritation and swelling , stinging , itching , burning , eye redness , blurred vision , dimming of lights , and allergic
24 September 2024 reactions , including itching and hyperemia . Thankfully , there are four different kinds of eye drops . So , if one kind is not tolerated well , there are options available .
For those who don ’ t tolerate any of the available glaucoma eye drops or who are looking for a more permanent solution , there is laser treatment or eye surgery . These each come with greater costs and certain risks . As such , one may want to try the eye drop approach first to determine its effectiveness . Some people may require a combination approach , i . e ., eye drops and laser treatment , to effectively control IOP .
Emotional Stress a Trigger for Glaucoma ?
Numerous studies have focused on the high incidence of stress , anxiety , and depression prevalent in glaucoma patients due largely to worst-case scenario fears of potential blindness . But can emotional stress itself possibly cause glaucoma ? The jury is still out , but what studies have shown is that emotional stress runs the risk of accelerating glaucoma ’ s progression . In Acute emotional stress as a trigger for intraocular pressure elevation in Glaucoma ( 2019 ), the study found that “… acute emotional stress could severely affect IOP in patients suffering from glaucoma . This could be important when looking after glaucoma patients . It would also suggest that the personality types , and the emotional and social context are more factors to take into account in glaucoma studies .” 1 A more expansive study in 2020 came to much the same conclusions . 2
Cannabis as a Treatment for Glaucoma
In the original 1971 study , Marijuana Smoking and Intraocular Pressure , Robert S . Hepler , MD , and Ira R . Frank , MD , found there to be a 15-20 % lowering of IOP with smoked cannabis . 3 Subsequent studies have largely confirmed the 1971 study while also noting that even much smaller doses could be consumed with equal or even better IOP-lowering results . 4 These figures rivaled pharmaceutical glaucoma eye drops . In those early years , many ophthalmologists were enthusiastic . However , that enthusiasm soon enough waned , and this is not necessarily because they ’ re all shills for Big Pharma ( which many are not ). The problem comes down to practicalities .
Glaucoma eye drops lower IOP for up to 24 hours , whereas smoked cannabis lowers IOP for only three to four hours . To achieve the same results , one would need to consume cannabis six to eight times every 24 hours . Some might consider edibles a viable alternative since they remain active in the system longer . The problem is there doesn ' t appear to be any clinical glaucoma studies using edible cannabis products . As such , we simply don ’ t know if edibles do , in fact , maintain a lowered IOP and for how much longer than smoked cannabis .
CBD and Glaucoma
Several studies have shown that CBD has no effect in lowering IOP . As such , it ’ s not a substitute for THC . Moreover , studies have shown that it also interferes with the pressure-lowering effects of