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Can CBD and THC in Cannabis Be Used for Glaucoma Treatment?

September 22, 2016
Ophthalmology concept. Male patient under eye vision examination in eyesight ophthalmological correction clinic
Glaucoma is a common eye condition that often causes optical nerve damage, and when left untreated, can lead to blindness. In the U.S., more than 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. Recognized near universally in medical marijuana states as a qualifying condition, increasing numbers of people have turned to cannabis to treat their condition. But should they?

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 plays in disease, what promise does the future hold for developing cannabinoid-derived medications to treat cannabis?

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. Studies have shown one out of four Alzheimer’s patients also likely has a diagnosis of glaucoma. In fact, glaucoma appears to be a significant predictor of AD. A precise cause of glaucoma, however, remains a mystery and continues to elude the scientific community.

Related

Is Cannabis Part of an Alzheimer’s Cure?

Current Glaucoma Treatment Options

current treatments for glaucoma

Because intraocular pressure (IOP) influences 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.

Can Cannabis be Used for Glaucoma Treatment?

Going back to the 1970s, studies have shown that cannabinoids can alleviate glaucoma-related symptoms because they lower the intraocular pressure (IOP) and have neuroprotective actions. For example, in 1971, one of the first studies of its kind found ingestion of cannabis lowers IOP by 25 to 30 percent.

Despite the findings from early research, very few ophthalmologists support the use of medical marijuana in patients with early to mid-stage glaucoma. The main issue ophthalmologists have with cannabis is that the potential adverse effects — particularly smoking cannabis — outweigh the short term benefits. For example, smoking can lead to unstable intraocular pressure, thereby increasing 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 per 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 as a treatment. At the end stages of glaucoma, it’s less about directly targeting the 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,” said Bainnson. “[However,] there are some patients with end stage pain and nausea who may benefit [from medical marijuana], but not from the glaucoma point of view.”

Could Cannabis-Based Treatments Play a Greater Role in the Future?

cannabis based treatments for glaucoma

The body’s own internal cannabinoid system, called the endocannabinoid system (ECS), is one of our most important physiological systems. Nearly every aspect of our health — including inflammation, immune response, neuroprotection, pain modulation — are all dependent on the ECS. Given the vital role of the ECS, particularly in neuroprotection and inflammation, many scientists believe the development of cannabinoid-based medications could be immensely useful in treating (and preventing) glaucoma.

Cannabinoid receptors are prominent in ocular tissues responsible for regulating intraocular pressure. A promising area of research would be to develop cannabinoid-derived medications that target these tissues. Cannabinoid-derived medications could be developed that serve two roles: lowering IOP and protecting retinal cells.

Related

Cannabinoids 101: What Makes Cannabis Medicine?

Evidence suggests two cannabinoid agonists — WIN 55212-2 and anandamide — and several cannabinoids including CBD and CBG (cannabigerol), may be good candidates to develop as therapeutic agents, particularly because even when administered topically (directly to the eye), they are well tolerated.

However, challenges not unique to cannabis persist. Oral preparations are not good because bioavailability is poor and absorption is too unpredictable. Inhalation isn’t ideal, because the effects don’t last long enough. That leaves topical preparations. And, currently all forms of eye drops — while superior to oral and inhalation administration — do a poor job at penetrating intraocular tissues. Up to 95% of an administered dose fails to reach the intended target.

Related

What are cannabis topicals and how do they work?

While cannabis, as it is administered today, may not be an ideal treatment for glaucoma, the development of cannabinoid-derived medications represent promising future directions. And, whether or not cannabis is an ideal glaucoma treatment, there are some people who swear by it as being a godsend for their glaucoma. Others use cannabis 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.

Jeremy Kossen's Bio Image

Jeremy Kossen

Jeremy is a contributing writer at Leafly. He is a best-selling author, podcaster, and entrepreneur.

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  • E. A. Becker

    I just wanted to thank whomever it was that recommended medical
    marijuana. The high CBD/ low THC strain has helped me go from 9+
    migraines a month to one or two. Seriously amazing stuff.Thanks to Dr Megan.You can reach her via dr.megan.ann@gmail.com for inquiries if interested….

    • Jeremy Kossen

      High CBD should do it!

      • Lady Diane

        I read “somewhere” on net recently that really, CBD actually works better with THC. You can get a very low THC/high CBD oil and not have to smoke it either. Usually taken 2x a day. I’m not a doctor! I am a patient who is learning much about the new products available. Of course, if for a child, or if you really can’t tolerate the THC, Cannabis oil seems to be over the counter in many forms (at least here in FL – CBD only; For combination therapies, you have to have a qualifying condition). It’s very mild compared to smoking (the THC I mean).

        • FLW

          > CBD actually works better with THC

          Of course, that depends on the problem you’re trying to alleviate.

    • FLW

      Maybe if you took more CBD per day, you could get those migraines down to Zero. Are you being advised against doing so?

    • RL Masterpiece

      My close friend has seizures and he smokes mj and it really helps him. I, myself vape mj for my glaucoma I was born with. It also helps me.

      • Marlene Dekarz

        Hi may I ask if you have sturge Weber syndrome with glaucoma. I have very severe glaucoma (10% vision left) and looking for a solution to get the pressure down.

        • Tanya

          Check out CBN rather then CBD. 🙂

  • Mr Fix IT

    I have glaucoma and for the first year I used the two types of drops prescribed and they brought my IOP down. In year two, I incorporated cannabis. Initially smoking only and now I make my own canna-coconut oil and use it to dose 3 times a day. My doctor was amazed at the results. My IOP is like those of someone without glaucoma!!!!!

    • Pam F

      Would you mind sharing how to make the canna-coconut oil? Thanks.

      • Mr Fix IT

        Pam, the easiest way is to buy a Magical Butter machine. However, there are several other methods, all of which take at least 6 hours. The Magical Butter machine is no more than 2 hours, after decarbox. Hope this helps https://www.leafly.com/news/food-travel-sex/recipe-how-to-make-basic-cannabutter

        • Pam F

          Thank you so much, excellent.

        • Joan Dube’

          HI What do you use and what dosage? Thanks

    • Kim Lambert Oman

      So did you switch from the pharmacy drops to cannabis oil? Or do you do both?

      • Mr Fix IT

        I do both and it’s working…plus I feel good

        • Kim Lambert Oman

          I was hoping to hear that you do the pot only. I wish they would do some scientific trials on that, I would love to be a guinea pig,

  • Garrett Elmer

    I know people should not advertise but I go to Cannacrude.com and buy my Cannabis Oil which I use for my ADHD and restless nights : ( Theres a lot of scammer websites so be careful people!!

  • I have been managing my Glaucoma with cannabis oil, a healthy diet, and proper supplementation for the past 3 years. It took me a long while to figure it out, but I’ve stopped mine in its tracks and actually improved my vision… It’s a little bit of work, but my eyesight is worth it.

    • Theron James

      What brand and dosage do you use of cannabis oil. I am looking for a cannabis based treatment protocol for glaucoma.

      • Hey Theron, I attack the condition from many different angles. I’m a holistic health practitioner and I’m good at figuring things out… so I used myself as a Guinea Pig. 🙂

        I currently use capsules with a mixture of thc/cbd… a high thc tincture with some cbd and cbg, a topical cream with thc, cbd and cbn, and a roller ball that has thc, cbd, cbdn… Plus I use vape cartridges for easy microdosing on the road during the day. I vape 3 different cartridges depending on my needs. high thc only or 1:1 thc:cbd or 1:2 thc:cbd.

        It’s a lot of different stuff, but it enables me to see.. which is why I do it…

        Remember this… Getting good quality oil is number one. All the stuff I get is from organic pesticide free herbs that were sun grown in the ground… The extraction process is critical, as well as the material used during the extraction process.

        There are lots of steps required from seed to oil, to insure that you can get the benefits from the oils.

        Hope that helps

        • Theron James

          Thanks so much! Very helpful.

        • Pam F

          Do you know if this can be used for treating animals with glaucoma, i.e., horses, dogs, cats?

          • Rhea Graham

            They have and EndoCannabinoid System just as we do, so yes.

        • Theron James

          Hi Al, I’ve been researching for good sources and brands thc/cbd. Please share any trusted sources. Thanks!

    • Joan Dube’

      AL- I have heard you talk about glaucoma but need to know your plan- dosage etc….. would love to treat my glaucoma too- thanks jtd52@aol.com

    • Damian Ivanov

      Al Morentin – can you be more specific what to buy and where for glaucoma ?
      link to web store or something ?

    • Brenda Bigelow

      would you give more info on exactly what u do, the drops eritate mt eyes and drive me crazy I con’t live like this.

  • Arlene Kopycienski

    I’m on 3 different eye drops for Glaucoma, that I administer up to 3x’s a day. I’m new to this site and just received my medical marijuana card. I have NO IDEA what to buy to help keep my pressure down without taking 7 eyedrops a day. Would appreciate any advise from anyone that is going through the same.

    • Lady Diane

      I read “somewhere” on net recently that really, CBD actually works better with THC. You can get a very low THC/high CBD oil and not have to smoke it either. Usually taken 2x a day. I’m not a doctor! I am a patient who is learning much about the new products available. Of course, if for a child, or if you really can’t tolerate the THC, Cannabis oil seems to be over the counter in many forms (at least here in FL – CBD only; For combination therapies, you have to have a qualifying condition). It’s very mild compared to smoking (the THC I mean). Even if you stay on your current medications, this will help your system deal with those meds, perhaps even be able to cut down? Google Trulieve, they are a dispensary in Florida. Great website with lots of info, confusing, yes. But, like me, keep reading it over and over. You’ll understand. Of course, we don’t have smokable cannabis legalized here, even for medical. But there’s too many variables in smoking it, in my mind. Good luck!

      • Tanya

        I just two articles that say CBD may be harmful for glaucoma folks due to the fact that CBD can increase pressure causing further damage. CBN (another cannabinoid) on the hand is a neuroprotectant and can work better in protecting the optic nerve from further degeneration.

    • Joan Dube’

      Arlene were you able to figure out how to treat glaucoma? I need to know where to start!

    • Sue Vishio

      Arlene
      What have you found out. We are new to this. 5 eye drops 3x a day and pressures still not under control
      Sue

  • GeorgeDurland

    I have glaucoma and live in Florida, so I am in the process of getting my medical cannabis card. It is my plan to use both eye drops and cannabis to control my ocular pressure, any advice on this would be appreciated

    • Sue Vishio

      George.
      We live in Fl also and my husband has end stage glaucoma and has lost his sight in one eye 15 years ago. The pressures in his other eye are starting to fluctuate too much. He is using 5 eye drops 3 x a day and has had glaucoma for 37 years. Who have you spoken to or have you found anyone that can advise using both drops and marijuana or CBD with thx
      Thanks for any reply

      Sue

  • Anto

    Can raw, fresh-picked cannabis leaves taken orally be used to treat high IOP?
    Or do the cannabinoids need to be decarboxylated to be effective?

    I.e. are CBDA and THCA effective in treating glaucoma? If so this would be the best way to take them as eating the raw leaves or drinking them juiced has no psychotropic effects and doesn’t interfere with work and driving.

    • Willnot Censor

      Interesting question. They said here that a study showed a 25% to 30% decrease in intraocular pressure by eating it. I don’t think they baked it first, but could have been a edible baked cannabis for sure. All I know is that smoking cannabis does reduce pressure and that full profile oil with carrier sublingual works also. Yes, the oil is decarboxylated. I don’t agree with this article talking about separating elements out. This is the problem with pharma and drug therapy today. Leave the plant alone. The synergistic effects of full plant extracts has been know for throughout history. Today we have the ability to extract the full cannabinoid/terpene/flavonoid profile and decarb appropriately, but that is another story.

  • Rich

    I found an article about the first person who legally used marijuana for medical use was for treatment of glaucoma in 1975. Follow this link to see for yourself, https://www.projectcbd.org/about/cannabis-culture-history/alice-oleary-randall-court-case-launched-medical-cannabis-movement

  • Willnot Censor

    I found this educational but a little left unanswered. I have seen oral full profile decarbed cannabis reduce IOP significantly. I agree to avoid smoking. Many here have commented that they found years ago about cannabis oil reducing IOP. Why is this not being used and so unknown? Because Big Pharma wants it that way. Many want to separate/isolate elements like pharma. The oil is full profile all natural. Here is the kicker that will blow their objections away; the properly prepared oil provides significant reduction of IOP with micro dosing. That means You Don’t Get High! Most Pharma drugs have debilitating side effects for many; and they have the nerve to attack the effects of cannabis when taken at a dose that causes improved emotional and psychological changes, saying that getting “High” is bad! The Opiod epidemic is much worse than the pot head problem. Lets compare death rates, lol. Full Profile Oil! EDCE (Ethanol Derived Cannabis Extract). Gently decarbed EDCE is full profile and should stay that way. Using a Sativa with high CBD is certainly the goal, but the other works also. The current obstacle to make this available to all is the overwhelming trend to isolate THC or CBD and use in potions, edibles, drops, lotions etc. Why? because CO2 extraction which is great at pulling out isolates has gained dominance in the market touting such great volume per dollar. What they don’t tell you is about the toxins/carcinogen problem or the lack of health benefits of isolates. Some are starting to use ethanol with proper and safe distillation procedures. The science of extracting full profile EDCE has come a long way. Some are selling devices to make the oil at home, they have some drawbacks and many misuse these devices. Knowledge is power. Glaucoma has hope now. We just need to spread the word.

    • Jess Jack

      I have Epilepsy and have recently been diagnosed with Glaucoma. The seizure meds that my Neurologist prescribes cost around 2600.00 for 90 days. I have heard of people who have Epilepsy, who are using Cannabis oil and swear by it. Now, that I been diagnosed with Glaucoma I have been using the eye drops. My Opthamologist just checked my eye pressure about a week ago and said that it was good. My biggest hurdle is that if I find a product that is good for one condition, it’s bad for the other. I have no problem putting in the eye drops. But I just don’t want to use this super expensive anti-seizure medicine forever. It doesn’t work all of the time either. I know that there is no magic pill for everything, but would it be safe to use the Cannabis oil to see if it works?

      • yiehom

        Why not just give it a try? It never killed a single person in 10.000 years !!!

        • Jess Jack

          This won’t get me high, right? An ‘acquaintance” of mine gave me a Rice Krispies treat and whooooa !!!! Yeah I was a little scared. But it DID make me chill for awhile. I would consider using Cannabis, but. I can’t go through that high again.

  • Robin Handy

    Just shown 3rd consistent improvement by smoking only. Today eye pressure was 11 and 14. Was 22 and 24. Using gorilla glue strain, grown outdoor. Results from despencery weed not as good, 16 to18. All is good found a way to not taking meds that put more into the emergency room. Have had glaucoma since 2011. Last year is the only lasting improvement.. the meds almost killedme.

    • Jill Holis

      Are you smoking, vaping, consuming oil, topicals, edibles? And, what’s the THC/ CBD ratio?

  • Penelope Walker

    As a 37-year old mom with OAG, the mention above of a possible link between glaucoma and Alzheimer’s Disease really petrified me. So, opting for critical thinking skills and a personal quest for first-hand sources, I decided to dig further into this frightening possibility. According to reliable NIH information, it’s important for our community (those of us with glaucoma) to understand we are *not* at an increased rate of developing Alzheimer’s Disease.

    Please read the abstract linked in the provided scientific study from NIH that discredits this theory:

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3523354/

  • Kris Castillo

    Don’t mean to be preachy preachy but in the Holy Bible it clearly says, but was actually used as a metaphor, that a tree can be judged by its fruit: Luke 6:43 KJV says, “For a good tree bringeth not forth corrupt fruit; neither doth a corrupt tree bring forth good fruit.” In all honesty, this debate, if marijuana is good or bad for you, can potentially come down to this verse. In my opinion I’m basing this on the fact that doctors still prescribe mmj in the late stages of glaucoma so I feel it can heal and thus still a good tree. Thanks

    • Tanya

      I agree. I’m a christian and for years thought of cannabis as the “devils” lettuce lol. When my husband got cancer I started to do my research and found a whole other world in Cannabis healing. I now am a Cannabis Caregiver and Cannabis Research Specialist. I work for a medical dispensary. There is a fine line between abuse and good use. The same applies to opiods, while greatly needed at times can be abused just as cannabis can.

  • Jen Smith

    I wanted to say that I do not live in a state that has legal medicinal or recreational marijuana. My spouse was diagnosed with Open Angle Glaucoma many years ago and because of healthcare costs he cant see a doctor for ongoing treatment, however as daily users the symptoms of Glaucoma are nonexistent. Living in a state where you have to depend on the black market there are times when it is unavailable due to several factors, we all know this, and when this happens, my spouse suffers with the symptoms, extreme pressure,severe migraines and blurred/distorted vision. Marijuana being in his system daily, its like he never had/has Glaucoma. The lobbying against marijuana for medical purposes is infuriating. The last time he saw a doctor he explained that marijuana worked better at controlling the symptoms than drops he has tried over the years, and of course he was told just try another Rx, blah blah blah. Some Doctors wont listen to their patients, so he has not seen a doctor for a while and marijuana for him is the only way to treat his Glaucoma.

  • B.Atkinson

    New studies show CBD may not be good for glaucoma. THC yes, CBD maybe not. has me rethinking my 1:1
    https://www.thefix.com/how-cbd-may-complicate-glaucoma-treatment

    • Tanya

      Check out the cannabinoid CBN. CBN it a neuroprotectant. Glaucoma is degeneration of the optic nerve. 🙂

  • 5_hearing5

    CBD in marijuana may worsen glaucoma, raise eye pressure!!!

    https://www.sciencedaily.com/releases/2018/12/181217151537.htm

    If this report is true then I shouldn’t be buying CBD oil to manage stress because it could make it could damage the optic nerve. So how can I use cannabis to treat Glaucoma and stress ?

  • Eddie Perez

    Does microdosing throughout the day work to lower IOP?