Cannabis and Glaucoma

 

"I have personally examined a large number of those between the ages of 40 and 60 years, and have found them to be not only sound in all their internal organs, but also of good bodily frame. Further, what might appear to be a strange thing is that most of them have even preserved good vision. Cataractous condition of the lens is, I observe, an uncommon thing among those who take bhang in moderation." 

 

 - Assistant Surgeon, J. E. BOCARRO, Lecturer, Medical School, Hyderabad (Sind), Witness Statement to Indian Hemp Drugs Commission, 1895

 

 

'Fourteen percent of all blindness in America is from glaucoma, a progressive loss of vision. Cannabis smoking would benefit 90% of our 2.5 million glaucoma victims, and is two to three times as effective as any current medicines for reducing ocular pressure! Cannabis use has no toxic side effects to the liver and kidneys; nor is there any danger of the occasional sudden death syndromes associated with the legal pharmaceutical glaucoma drugs /drops. Many California eye doctors, through the 1970s, ‘80s, and ‘90s, discreetly advised their patients to use “street” marijuana in addition to (or to mitigate) their toxic legal glaucoma medicines. Since November 1996, California doctors can legally recommend, advise or tacitly approve cannabis use by their glaucoma patients who may then grow and smoke their own marijuana, or go to one of the 600 plus Cannabis Buyers’ Clubs to acquire medical marijuana. (Harvard; Hepler & Frank, 1971, UCLA; Medical College of Georgia; U. of North Carolina School of Medicine, 1975; Cohen & Stillman, Therapeutic Potential of Marijuana, UCLA, 1976; National Eye Institute; Records of Bob Randolph/Elvy Musika, glaucoma patients who receive 300 joints a month from the federal government 1975, 2007), Tashkin, Dr. Donald UCLA, 1976 -2007.'

 

 - The Emperor Wears No Clothes by Jack Herer

  

 

One of the studies that I found, regarding the medical benefits of cannabis, spoke about using cannabis to treat glaucoma. Glaucoma is a disease of the eyes affecting many people worldwide. It basically involves blockages in the fine capillaries that surround the retina and connect to the optic nerve. This affects blood circulation and can result in a build up of ocular pressure and eventually a rupture of the optic nerve rendering the eye non-functional. Hence, this is a serious disease contributing to complete or partial blindness in many cases. The known methods of treatment involve puncturing holes in the capillaries to remove the blockages, and the daily use of eye drop based medications to keep the ocular pressure within normal ranges. In recent times, asking people to go for surgeries to treat glaucoma is increasingly becoming common, with ophthalmologists recommending it more and more frequently.

Interestingly, glaucoma was one of the earliest qualifying conditions as medical cannabis started becoming legal in states like California and Colorado. However, in the past few years the use of cannabis for treatment of glaucoma has not risen much in popularity. Some medical associations have also come out with statements that cannabis does not help with glaucoma. What is well established is that in the 2-3 hours that follow the consumption of cannabis, ocular pressure in the individual is low, but it starts to gradually increase once again as the effects of cannabis wears out, requiring a subsequent dose and more frequent dosing. Now this is surely not an issue for a cannabis lover as the more opportunities that present themselves for dosing with cannabis, the better it is. An average cannabis user is likely to dose on cannabis at around time intervals of 2-3 hours, which works perfectly for ocular pressure. However, a person using cannabis purely as a medication without enjoying its pleasurable entourage effects (yes, unbelievably, there are also people like that), may find frequent doses a daily burden. Another study has stated that the compound delta9-tetrahydrocannabinol(THC) is good for lowering ocular pressure, whereas the compound cannabidiol(CBD) raises ocular pressure, hence suggesting that high THC cannabis is good for reducing ocular pressure in glaucoma. This, of course, runs counter to the general impression in society that THC is evil, and the push from regulators to keep THC banned or under minimal levels in cannabis products.

Cannabis was used by craftsmen who worked with intricate designs in the past in India. This may have also been because of its benefits to the eyes besides aiding in concentration and reducing fatigue. An example from the Indian Hemp Drugs Commission Report, in this regard is as follows - '"The zaveris (goldsmiths, those who deal in gold, and jewels, and pearls, etc,) always take bhang in order to be able to accurately value their articles of trade. - Evidence of DESAIBHAI KALIDAS, Brahmin (Khedaval), Government Pleader and Public Prosecutor, Kaira.'

 

For one thing, a cannabis user is generally more connected to his or her surroundings, tuned in shall I say. What this means for the eyes is that a cannabis user generally exercises her eyes a lot more by focusing at various lengths and looking in different directions. These activities may also aid in improving the health of the eyes, keeping it moist, reducing inflammation and pain, etc. The favorable use of cannabis for head and neck diseases also hint at the fact that cannabis is likely to be beneficial for the eyes as well and hence, a potential aid in the treatment of glaucoma. The Indian Hemp Drugs Commission of 1895,  in its Report, states regarding the immediate effects of cannabis smoking, that "it brightens the eyes". From a personal standpoint, I have found that one of the immediate effects on cannabis consumption is a clarity of vision. It is akin to using the windshield wipers of your car. Everything appears brighter, clearer, and more colorful. The details of many objects, that one would typically miss under other circumstances, stand out much more clearly under the effects of cannabis.

Whatever the reasons, cannabis for glaucoma seems to have lost its popularity a bit in recent times. But if it has benefits, then to ignore such an affordable and, if legalized recreationally, widely accessible and safe medicine for glaucoma, that reduces invasive, expensive surgeries and medications would surely be foolish. Especially for the elderly.

Related articles

The following list of articles taken from various media speak about the above subject. Words in italics are the thoughts of yours truly at the time of reading the article.

'Cannabis has medical uses because of its possible neuroprotective properties. Our study supports the possible neuroprotective effects associated with cannabis through RNFL data.

According to our best knowledge, this is the first study investigating the association between RNFL [retinal nerve fiber layer] and drugs, particularly cannabis.'
https://www.tandfonline.com/doi/abs/10.1080/10550887.2020.1754109

Getting high on THC is good for your eyes, especially if you are male. The study highlights a positive benefit of THC in controlling glaucoma related IOP. It also highlights the importance of not stereotyping THC and CBD and slotting them into rigid categories of good and bad. Having various combinations of marijuana's compounds available at all times, preferably in their naturally occurring ratios as found in different strains in nature, is most important so that we can understand their uses and benefits before we give in to the human impulse of diving into modifying the plant through hybridization and breeding to increase some compounds and eliminate others...

'Our chief findings in normotensive mice were that THC lowers pressure substantially and for at least 8 hours, through a combined action at two receptors, CB1 and GPR18. This effect was sex-dependent, with much stronger responses in male mice. CBD in contrast had two opposing actions on IOP: raising IOP in wild-type animals but lowering it in CB1 knockout mice likely via GPR18. Finally, at equal concentrations CBD prevented the IOP-lowering effects of THC. '
https://iovs.arvojournals.org/article.aspx?articleid=2718702


'Fourteen percent of all blindness in America is from glaucoma, a progressive loss of vision. Cannabis smoking would benefit 90% of our 2.5 million glaucoma victims, and is two to three times as effective as any current medicines for reducing ocular pressure! Cannabis use has no toxic side effects to the liver and kidneys; nor is there any danger of the occasional sudden death syndromes associated with the legal pharmaceutical glaucoma drugs /drops. Many California eye doctors, through the 1970s, ‘80s, and ‘90s, discreetly advised their patients to use “street” marijuana in addition to (or to mitigate) their toxic legal glaucoma medicines. Since November 1996, California doctors can legally recommend, advise or tacitly approve cannabis use by their glaucoma patients who may then grow and smoke their own marijuana, or go to one of the 600 plus Cannabis Buyers’ Clubs to acquire medical marijuana. (Harvard; Hepler & Frank, 1971, UCLA; Medical College of Georgia; U. of North Carolina School of Medicine, 1975; Cohen & Stillman, Therapeutic Potential of Marijuana, UCLA, 1976; National Eye Institute; Records of Bob Randolph/Elvy Musika, glaucoma patients who receive 300 joints a month from the federal government 1975, 2007), Tashkin, Dr. Donald UCLA, 1976 -2007.' - The emperor wears no clothes by Jack Herer


Although it is true that marijuana does lower intraocular pressure, we must educate our patients on the limited effects, the frequent dosing required for therapeutic effect, and the unacceptably high number of adverse effects that come with this frequent dosing.
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2478546


'Currently, only Texans diagnosed with "intractable epilepsy" are allowed to use cannabis that contains low levels of the psychoactive ingredient tetrahydrocannabinol, or THC. Menéndez's bill would dramatically expand this law by legalizing medical marijuana for Texans with certain other debilitating conditions, including cancer, glaucoma, HIV, Alzheimer's, PTSD, autism or chronic pain, nausea and muscle spasms'
https://www.dallasnews.com/news/texas-legislature/2019/01/03/texas-marijuana-advocates-get-fired-decriminalize-pot-2019


The 21 qualifying conditions for medical marijuana in Ohio includes glaucoma

'The Enquirer set out to determine how many Ohioans could be eligible for medical marijuana under the 21 qualifying conditions from the Ohio Department of Health, the U.S. Centers for Disease Control and Prevention and private nonprofits that raise money for medical research. For many diseases, the numbers of patients are estimates, since the government does not track patient counts for every ailment. The conclusion: About 3.5 million Ohioans deal with at least one of the qualifying conditions. Ohio's population is 11.66 million'
https://www.cincinnati.com/story/news/2018/07/18/3-10-ohioans-eligible-medical-marijuana-card/784017002/


Minnesota's list of qualifying conditions for medical marijuana includes glaucoma


Pennsylvania's list of medical conditions qualifying for medical marijuana includes glaucoma

' In particular, I would really love to see anxiety, depression and ADHD added,” Spaar said. '
https://triblive.com/state/pennsylvania/14367032-74/pennsylvania-to-consider-more-conditions-that-should-qualify-for-medical-marijuana


'Dr. Bisasor-McKenzie alluded to the Report of the CARICOM Regional Commission on Marijuana 2018, which states that access to medical marijuana should be facilitated for qualifying conditions in which there is clear evidence of its therapeutic benefits and for debilitating life-threatening conditions that are intractable to treatment, and where there is evidence of possible benefits.

“These include patients on chemotherapy with nausea and vomiting, glaucoma, asthma, anorexia and weight loss in AIDS, cancers, anorexia nervosa, chronic and neuropathic pain, multiple sclerosis, sleep disorders and some neuropsychiatric disorders” she outlined.'
https://jis.gov.jm/health-ministry-supports-conditional-use-of-cannabis-for-research-and-meidicinal-purposes/


'When we reviewed its medical uses in 1993 after examining many patients and case histories, we were able to list the following: nausea and vomiting in cancer chemotherapy, the weight loss syndrome of AIDS, glaucoma, epilepsy, muscle spasms and chronic pain in multiple sclerosis, quadriplegia and other spastic disorders, migraine, severe pruritus, depression, and other mood disorders. Since then we have identified more than a dozen others, including asthma, insomnia, dystonia, scleroderma, Crohn’s disease, diabetic gastroparesis, and terminal illness. The list is not exhaustive.'
http://rxmarijuana.com/old_medicine.htm


'Under a law passed in 2015 and tweaked twice since then, Louisiana is allowing therapeutic cannabis to treat a long list of diseases and disorders, such as cancer, a severe form of cerebral palsy, seizure disorders, epilepsy and muscular dystrophy. Earlier this year, lawmakers added glaucoma, severe muscle spasms, intractable pain, post-traumatic stress disorder and Parkinson’s disease.'
https://apnews.com/89637c7abda94107a41f70c6ab1c044f