Medicinal cannabis is often presented as an alternative treatment for glaucoma. Although there is evidence that cannabis lowers intraocular pressure, its role as a viable glaucoma therapy is limited by a short duration of action, psychotropic effects, and possible tachyphylaxis.
Glaucoma is one of the leading causes of blindness in the world. In spite of the diverse therapeutic possibilities, new and better treatments for glaucoma are highly desirable. Cannabinoids effectively lower the intraocular pressure (IOP) and have neuroprotective actions. Thus, they could potentially be useful in the treatment of glaucoma. The purpose of this article is to provide the reader with an overview of the latest achievements in research into the potential use of cannabinoids for glaucoma.
Cannabis/marijuana is the most frequent illicit drug used today for recreational purposes. Yet it is not widely known that the cannabis plant (Cannabis sativa; Latin for “planted hemp”) (fig 1) is one of the oldest drugs used for medical purposes. Its therapeutic use was first recorded in a classical medicine book by the Chinese emperor Shen Nung in 2737 bc. The medical use of cannabis was also known in other ancient cultures throughout India, Assyria, Greece, Africa, South America, Egypt, and the Roman Empire.1
Symptoms and Side Effects of Glaucoma
Cannabis can control IOP and is neuroprotective. It also has painkilling and anti-inflammatory properties that can go a long way toward relieving your symptoms. Some strains of medical pot also work against nausea and vomiting associated with a glaucoma attack.
Medical pot is a good alternative if you’ve tried conventional glaucoma treatments and feel you need something gentler, yet still effective at reducing your eye pressure. You’re more likely to find relief from your everyday symptoms without provoking any unwanted effects in the process, too.
Symptoms of angle-closure glaucoma include:
- Seeing halos or colored rainbow-like rings around lights
- Sudden blurry vision
- Severe head and eye pain
- Sudden sight loss
These symptoms are very pronounced, and eye damage happens rapidly. Make an appointment with an ophthalmologist without delay if you experience any of the above.
Symptoms of open-angle glaucoma are less obvious than that of acute angle-closure glaucoma. There are typically no painful symptoms or early warning signs of open-angle glaucoma. The disease develops slowly, and you might not detect any sight loss for several years, especially if you don’t see your eye care practitioner regularly. Your vision may remain sharp until you’re in the later stages of the disease. You perhaps won’t notice your peripheral vision is deteriorating.
Unfortunately, the disease can be rather advanced by the time you’re usually aware of any vision loss. Glaucoma can lead to blindness if not treated. Regular eye examinations are crucial for this reason.
Can cannabis help with glaucoma?
Glaucoma is a common eye condition that often causes optical nerve damage and when left untreated can lead to blindness. In the US, about three million Americans live with glaucoma; globally, the figure is close to 60 million. Glaucoma is recognized as one of the leading causes of irreversible blindness.
Since 1980, surgical procedures and treatments have improved significantly, cutting the risk of developing blindness nearly in half. Nonetheless, while treatment has improved, the number of effective topical drugs remains limited.
Almost universally recognized in medical marijuana states as a qualifying condition, increasing numbers of people have turned to cannabis to help their condition. But is marijuana actually good for glaucoma?
Given the improvement of existing glaucoma treatments, do the benefits of medical cannabis outweigh the potential side effects or risks? Likewise, given the vital role the body’s endocannabinoid system (ECS) plays in disease, what promise does the future hold for developing cannabinoid-derived medications to help with glaucoma?
What causes glaucoma?
Evidence increasingly suggests glaucoma—now widely considered to be a neurodegenerative condition—has a connection to other neurodegenerative diseases like Alzheimer’s disease. Glaucoma appears to be a significant predictor of Alzheimer’s. A precise cause of glaucoma, however, remains a mystery and continues to elude the scientific community.
Current glaucoma treatment options
Because intraocular pressure (IOP) influences the onset and progression of glaucoma, ophthalmologists prescribe treatments that target intraocular pressure. In fact, the only way to prevent vision loss or eventual blindness is to lower IOP levels.
Depending on the severity and progression, ophthalmologists may treat glaucoma with medications such as prescription eye drops, or, if necessary, surgery.
Why is marijuana used for glaucoma?
Going back to the 1970s, studies have shown that cannabinoids can alleviate glaucoma-related symptoms because they lower intraocular pressure (IOP) and have neuroprotective actions. For example, this 1971 study found that ingestion of cannabis lowers IOP by 25-30%.
Despite the findings from early research, few ophthalmologists support the use of medical marijuana for patients with early to mid-stage glaucoma. The main issue ophthalmologists have is that potential adverse effects—particularly when smoking weed—might outweigh short-term benefits. For example, smoking can lead to unstable intraocular pressure, thereby increasing the risk of permanent vision loss.
Further, because its therapeutic effects on glaucoma are short-term, patients would have to consume cannabis frequently—once every three to four hours.
Doctors claim that because glaucoma needs to be treated 24 hours a day, patients would need to consume cannabis six to eight times over the course of a day to achieve consistently lowered IOP levels. Such frequency is hard to maintain and could increase the risk of developing a cannabis use disorder.
However, when it comes to late-stage glaucoma, ophthalmologists are more inclined to embrace cannabis to help with the condition. In later stages of glaucoma, it’s less about directly targeting glaucoma and more about alleviating the accompanying symptoms.
According to ophthalmologist Andrew Bainnson, MD, “We’ve known for some time that medical marijuana is very effective for treating nausea and pain, but not so much for glaucoma. There are some patients with end-stage pain and nausea who may benefit [from medical marijuana], but not from the glaucoma point of view.”
How to Get Medical Marijuana for Glaucoma
Your ability to access medical marijuana for glaucoma will vary considerably based on where you live. Not every U.S. state has an approved medical marijuana program and those that do have varying eligible conditions. Be sure to check with your state’s medical marijuana laws before pursuing a cannabis treatment plan for your glaucoma.
If medical marijuana is permitted for glaucoma patients in your region, you need to consult with a state-certified doctor who will determine your eligibility. They will provide you with a diagnosis and authorize your use. Once you enroll as a medical cannabis patient with the state, you will likely need to wait for your medical I.D. card in the mail. In many states, a medical I.D. card serves as verification of your authorization to purchase and use medicinal marijuana.
For more information regarding medical marijuana treatment and your ability to access this substance, contact your doctor or a marijuana-savvy physician in your city who can help you get started on the patient enrollment process.
Cannabis isn’t a practical method for treating eye conditions
Glaucoma and other eye conditions cannot be treated with cannabis or other compounds derived from marijuana, such as CBD. That’s because eye pressure must be managed 24 hours a day to effectively treat glaucoma. It’s simply not practical to use marijuana constantly.
To reduce eye pressure in a noticeable way — and maintain that reduction — you would have to ingest about 18 to 20 mg of THC six to eight times a day, every day. Ingesting such a large amount of cannabis would dramatically affect your mood, mental clarity and (if smoked) lung health. You would not be able to drive, operate machinery or engage in many daily activities. Not to mention the cost of using marijuana every three to four hours, every day. Most patients could not afford this.
Ways to Use Medical Marijuana for Glaucoma
Marijuana is quickly growing as a top medicinal choice for patients for a variety of reasons — its diversity being one of them. As a patient, not only do you have the freedom to select from dozens of different strains, but you also have the ability to choose the intake method that is best suited your health. You may not want to smoke pot due to its negative health effects. There are so many more alternatives, though, and you’re sure to find the best method for you.
How do patients with glaucoma typically use cannabis? Here’s a look at some of the most common intake methods:
- Smoking: Smoking is the method that often offers the quickest relief from symptoms — a detail which is important for patients with glaucoma.
- Vaporizing: Vaporizing, also called vaping, is another inhalation method that brings you almost immediate relief. However, unlike smoking, it’s less likely to provoke throat discomfort or irritation. Bear in mind that you need to keep your vaping unit charged at all times. Also, the vaping kits can be expensive.
- Edibles: Today, edibles are available in a variety of flavors and forms. Edibles take a little time to kick in but provide a longer and more lasting effect. Many people like to take these, as they are discreet. You can either make your own or purchase these ready-made.
- Juices: You can blend fresh, raw pot leaves with some fruit juice. Taking a drink every four hours or so will keep your symptoms at bay.
- Sprays: Sprays come in a variety of pleasant flavors and are also discreet to use.
- Tinctures: Tinctures can be placed directly into your food and drinks, but can be expensive to buy.
- Pills/Tablets: Pills and tablets allow users to ingest their necessary cannabis supply in a discrete and accessible way.
Since every patient is different, it’s best to discuss your marijuana treatment options with a certified medical professional first.
Best Strains of Marijuana for Glaucoma
Pot continues to be prohibited at the federal level in the United States. Nonetheless, several states have legalized its medical and recreational use. You need to have a diagnosis of a condition that’s on your own state’s list of qualifying medical marijuana conditions to be approved to use medical cannabis for glaucoma.
You also need to have a medical cannabis physician’s recommendation, which will get you a medical pot card. As soon as you have this, you can visit dispensaries to buy the medical pot for your own specific needs.
There are several useful strains of medical marijuana for glaucoma that are readily available to buy from dispensaries. Each strain has its distinct effects. You should have a conversation with an experienced budtender and/or your medical cannabis doctor to figure out what strains may be best for your specific needs. In the meantime, look at this short list of useful glaucoma strains based on what symptoms you want to relieve.
1. Eye Pressure
Suffering from pressure behind the eyes can lead to optic nerve damage and even blindness. Thankfully, there are various cannabis strains that may be able to help relieve this. These include:
- Blueberry: Blueberry is a potent indica hybrid. It’s best to use at night, as it can make you feel sluggish. Not only does this strain relieve eye pressure, but it also provides pain relief, helping you to get a good night’s sleep.
- Maui Waui: Maui Waui is a commonly used and popular s It treats eye pressure, pain, anxiety and depression. You feel happy and uplifted when you take this strain.
- Cherry Kola: Cherry Kola is a potent indica strain that treats eye pressure.
CBD and THC in cannabis can relieve nerve pain. They reduce brain inflammation and regulate pain signals in your body. The following strains have good levels of neuroprotective terpenes and should help with your pain:
- SuperBud: SuperBud is an indica strain that’s filled with terpenes. It’s said to have almost narcotic effects and can also boost your brain.
- Jack Herer: Jack Herer is a sativa-dominant hybrid. The strain is full of natural painkillers and reduces tissue inflammation and stress.
- Sour Grape: Sour Grape is a hybrid strain that works on many levels. It can be used to treat nausea, pain and eye pressure, too.
3. Nausea and Vomiting
Nausea and vomiting attacks can be debilitating when you have glaucoma. The following medical pot strains can alleviate these symptoms:
- Durban Poison: Durban Poison is a sweet sativa strain. You get an energetic and uplifting experience and can feel quite upbeat and creative. Your symptoms of nausea and/or vomiting subside, and you can go about your day as usual.
- Trinity: Trinity relieves depression and stops you feeling nauseated. You may feel drowsy after having a creative and focused initial effect from this sativa strain. Try it out and see how Trinity affects you.
- Sour Diesel: Sour Diesel is an energizing sativa. It’s a good replacement for a morning coffee and will make you feel focused and positive.
Side Effects of Marijuana for Glaucoma
Having glaucoma is stressful. Worrying about your vision problems can take over your life. Depending on the type of glaucoma you have, you may have suffered a painful attack, or you could have no symptoms at all.
Your quality of life can be dramatically diminished if you have begun to or have lost your vision. You may not respond as well as you might have hoped to treatments. All that worrying can have a negative impact on your immune system, and you feel frequently fatigued. You may even develop clinical depression. You may lose interest in activities you once enjoyed, especially ones that require good vision and concentration.
Fortunately, if you’re adversely impacted by glaucoma symptoms, you have treatment options — including prescription eye drops, surgery and medical cannabis — that can help you maintain your vision and quality of life.
While cannabis, as it is administered today, may not be an ideal treatment for glaucoma, the development of cannabinoid-derived medications represent a promising future direction. And, whether or not cannabis is an ideal glaucoma treatment, there are some people who swear by it as a godsend for their condition, while others consume it as an adjunct to therapy, but not as their primary treatment.
If you or someone you know has successfully used cannabis to treat glaucoma, share your experience with us in the comments section.