Glaucoma

ALS and Medical Marijuana

Glaucoma

An ocular condition characterized by varying degrees of pressure resulting in damage to the optic nerve.

There are two main types of glaucoma:

Open-angle glaucoma. Also called wide-angle glaucoma, this is the most common type of glaucoma. The structures of the eye appear normal, but fluid in the eye does not flow properly through the drain of the eye, called the trabecular meshwork.

Angle-closure glaucoma. Also called acute or chronic angle-closure or narrow-angle glaucoma, this type of glaucoma is less common in the West than in Asia. Poor drainage is caused because the angle between the iris and the cornea is too narrow and is physically blocked by the iris. This condition leads to a sudden buildup of pressure in the eye.

Common symptoms include building pressure, referred to as intraocular pressure, and blurred and distorted vision. There is also neurodegeneration and excavation of the optic nerve associated with this disease. Glaucoma is one of the leading causes of blindness.

For most people, there are usually few or no symptoms of glaucoma. The first sign of glaucoma is often the loss of peripheral or side vision, which can go unnoticed until late in the disease. This is why glaucoma is often called the “sneak thief of vision.”

Detecting glaucoma early is one reason you should have a complete exam with an eye specialist every one to two years. Occasionally, intraocular pressure can rise to severe levels. In these cases, sudden eye pain, headache, blurred vision, or the appearance of halos around lights may occur.

If you have any of the following symptoms, seek immediate medical care:

  • Seeing halos around lights
  • Vision loss
  • Redness in the eye
  • Eye that looks hazy (particularly in infants)
  • Nausea or vomiting
  • Pain in the eye
  • Narrowing of vision (tunnel vision)

The Past

There are many pharmaceutical medications and eye drops used in the treatment of glaucoma. These include:

  • Timolol
  • Pilocarpine
  • Betaxolol

Eye surgery is also an option.

The Plant

Cannabis is an effective treatment of glaucoma due to its ability to alleviate the intraocular pressure symptomatic of the disease. THC is the cannabinoid believed to be responsible for this relief, which opens up a wide variety of strain options. The hybrid Silver Surfer, sativa Dr. Grinspoon, and indica Grand Hindu have all been reported as effective by individuals suffering from glaucoma.

High-CBD strains are not recommended for the treatment of glaucoma, as numerous patients have reported an increase in eye pressure with such strains.

Medical marijuana’s primary benefit for glaucoma patients is its effect on intraocular pressure (IOP). In one study, more than 80 percent of patients who smoked marijuana using an ice-cooled water pipe experienced a reduction in IOP of 16-45 percent. Another study using cannabinoids derived from marijuana found a significant drop in IOP in patients who took THC and cannabinoid oil. A third clinical trial also found that marijuana reduces intraocular pressure, as well as blood pressure overall.

Glaucoma is among the most common medical conditions treated with medicinal marijuana. There is no cure for glaucoma, but with your ophthalmologist’s guidance, you can combine marijuana with traditional glaucoma drugs to create an effective treatment plan to delay or avert surgical intervention.

The Process

Smoking and vaporizing high-THC cannabis, as well as the oral ingestion of edibles and capsules, are the most common cannabinoid treatment methods known to date for glaucoma.

Vaporizing or Vaping

If you don’t like the idea of smoke there is the option to vaporize. Vaporization does not use combustion to heat the medicine. Unfortunately there is some confusion out there about vaporizers. There are now hundreds of vaporizers to choose from. There are three basic types: pen, hand-help, and tabletop. The differences are in price, portability and size. Some vaporizers claim to be able to vaporize plant matter (flowers), wax and oils. Some can only do concentrates, some only oil. The most important difference is the method used to heat the medicine. There are basically two methods (with hybrids on the way)- conduction and convection.

True Vaporizing is done by convection, where air is heated, and in turn the hot air turns the medicine a to vapor which is then inhaled. Conduction Vaporizing happens when a hot element (metal plate, or bowl) touches the medicine. The medicine is placed directly in a metal or ceramic bowl or chamber that is heated which then heats the medicine and the smoke is inhaled. This is still combustion, and not truly vaporizing. This is closer to dabbing but with a much cooler heating element.

What’s Best for my Lungs?

The cleanest method to inhale medicine is true or convective vaporizing. It is better for your lungs since there is no burning or combustion.

Edibles

Edibles provide ways to eat or drink your medicine. Many medicated edibles and even bottled drinks are readily available at dispensaries. Be aware that most of the edibles at dispensaries are loaded with sugar and carbs. But basically what the edibles and drinks all contain are canna butter and/or canna oil. You can purchase these or easily make them at home to add to your own baked goods, snacks or even meals (especially if you are avoiding sugar or gluten).

The Patient

While research on the interaction of cannabis and glaucoma began in the 1970s, there have been few clinical trials to date. The 1976 Investigational New Drug (IND) program introduced by the FDA provided the first legal access of cannabis to glaucoma patient Robert Randall. Randall had accidentally discovered that smoking cannabis eased the intraocular pressure (IOP) of his glaucoma while smoking with a friend in 1973.

In 1975, he was arrested for growing marijuana, but went to the lengths of seeking out a UCLA researcher to back up his claim. He was able to prove that the cannabis was relieving the symptoms of the disease, and was able to successfully preserve his eyesight through the legal use of cannabis until his passing in 2001. Upon his death, NORML director Keith Stroup referred to Randall as the “father of the medical marijuana movement.”

In the case of Elvy Musikka, she’s been receiving medical cannabis from the government since she applied for the IND program in 1988. While blind in one eye, the container of pre-rolled joints she receives on a regular basis from the U.S. government keeps her eye pressure down, and she has maintained vision in the other eye successfully for over 20 years since being a part of the program. Interestingly enough, during a 2011 traffic stop wherein Musikka was a passenger, Oregon State Police attempted to confiscate the less than an ounce of cannabis she had on her. Following calls to Musikka’s physician, the DEA and U.S. Attorney’s Office, she was allowed to keep her medicine.

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