How to use CBD for Glaucoma | Everyting you need to know about

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How to use CBD for Glaucoma | Everyting you need to know about

Glaucoma isn’t a single disease but it is a group of eye conditions that severely affects or damages your optic nerve, which is responsible for carrying the visual signals to the brain, and in some cases it can even lead to permanent blindness.

This is the most common eye disease that affects people over the age of 60. It may occur at any age, but it is more prevalent among the elderly. It is known to have affected approximately 80 million people worldwide in 2020.

This is also referred to as the “sneak thief of vision” as it slowly and steadily robs you of your vision and finally causes permanent and irreversible damage to your optic nerve, if it is not treated in time. It usually comes without any early warning signs or symptoms. So a timely eye examination, which includes measurement of eye pressure, is recommended so that it leads to early diagnosis which can help to stunt the further progression of the vision loss.

Through this article, we will help you understand about the causes, types and the possible treatment of glaucoma.

Causes of Glaucoma

A healthy eye has a normal fluid pressure, known as the intraocular pressure. This pressure is created by the aqueous humour, which in turn is secreted by the ciliary body in the anterior section of the eye and this fluid is regularly drained via the small mesh-like opening called the trabecular meshwork into the canal of Schlemm.

When the amount of production of aqueous humour equals the amount of drainage, we say that the eye in is a healthy condition and maintains a healthy eye pressure. But when there is a slight built up of aqueous humour or the imbalance between the production rate and the drainage rate of the intraocular fluid either due to slow drainage process or due to partial or complete blockage at the narrow drainage angle, it may cause the pressure to rise above 21 mm Hg.

This elevated pressure flows throughout the inside of the eye and affects all the structure inside it. Over a period of time, high pressure keeps building and pushing against the optic nerve thereby gradually severely affecting the optic nerve.

As the nerve deteriorates, blind spots start accumulating in your field of vision which eventually leads to partial or complete loss of vision.

This loss of vision due to the damage in the optic nerve because of hyper-ocular pressure leads to a condition called the Glaucoma.

Glaucoma tends to run in families, so a routine eye examination is required to be done since this disease does not show any signs and symptoms.

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How is it produced?

There are some possible known factors that may be involved in the production of this illness. These are as follows:-

  • High blood pressure.
  • Poor or less blood flow to your optic nerve.
  • Medications such as some steroids.
  • Blocked drainage in your eye.
  • Dilating eye drops
  • Patients with thin cornea
  • Eye traumas- a severe injury to the eye may create conditions for glaucoma.
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Types of Glaucoma

An elevated eye pressure can affect many structures inside the eye and this in turn can cause different types of glaucoma. The frequently occurring types of glaucoma are as follows:-

  1. Open-angle Glaucoma- it is the most common and it is also known as the wide-angle glaucoma. The narrow angle of drainage between iris and cornea is open and it is fine, meaning the passage for the fluid to pass is clear but the fluid flows out at a slow pace thus leading to gradual build-up of the fluid in the anterior section of the eye.

This pressure built-up can eventually lead to damaged optic nerve, the more the damage the more the blind spots begin to occur. Though the blind spots are not noticed day to day until the optic nerve is significantly damaged and the spots become large.

  1. Closed-angle Glaucoma- it is also known as acute-angle closure or narrow angle glaucoma. The angle between iris and cornea becomes too small, thus affecting the flow of the fluid outwards and this imbalance causes a sudden built-up of pressure in your eye. Cataracts and farsightedness can be linked to it.
  2. Normal Tension Glaucoma- even when the eye pressure is normal, it is seen that the damage does occur to the optic nerve and this damage is caused by the condition called hyperperfusion. This can be known as the other type of open-angle glaucoma.
  3. Pigmented Glaucoma- this condition occurs when there is logging of the drainage canals due to tiny bits of iris’s pigments that get into the fluid inside your eye.
  4. Secondary Glaucoma- this occurs because of the added pressure inside the eye and the conditions such as cataracts and diabetes.
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Symptoms of Glaucoma

Since glaucoma does not show any early signs and symptoms, this requires discretion on the part of a patient. So it is important to have a regular check up with your ophthalmologist. The symptoms usually depend on what type of glaucoma you have, whether you have open-angle glaucoma or angle-closure glaucoma.

In case of open-angle glaucoma, the symptoms usually appear late but the main sign is loss of peripheral vision while in the angle-closure glaucoma the damage is usually quick and requires immediate medical attention. The main signs in this condition are:-

  • Seeing vision halos
  • Vision loss
  • Redness and pain in eye
  • Upset stomach or vomiting

People with conditions such as diabetes, thin cornea, high blood pressure and people who are over 40 years of age are at a greater risk.

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Diagnosis

Diagnosing glaucoma is not always easy, since the eye pressure changes from day to day and from hour to hour. Therefore a single eye pressure test may not detect the glaucoma condition, so need to have a regular check of your eye pressure by consistently visiting your ophthalmologist.

There is no single normal reference eye pressure that applies to everyone and the optic nerve damage can occur at different pressures and different people. So it is better to have a target pressure set specifically for you to protect your eye from greater damage.

So, here are some of the most trusted eye testing methods that ensure that your condition is properly detected.

  1. Eye Pressure Test/Tonometry – in this test the eye pressure is checked by putting a small dose of anaesthetic and a dye into the front of your eye and then by placing the tonometer on the surface of the eye the pressure is noted.
  2. Gonioscopy- with this you can detect the type of glaucoma you have by specifically checking the front part of your eye to see whether the drainage angle is open or closed or how muhis the flow of the fluid.
  3. Visual Field Test- or (perimetry) this test is for checking the areas of vision loss.
  4. Ophthalmoscopy/optic nerve assessment- this test is for testing the optic nerve damage. These eye drops dilate your pupils, and with the help of the eye scanner or light microscope, the technique usually known as the optical coherence tomography, you can check the damage of your optic nerve.
  5. Pachymetry- to check the thickness of the cornea.
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Treatment of Glaucoma

Even though the glaucoma is not curable, the progression of the disease can be somewhat halted with the modern medical treatments. The part of the vision that is already lost cannot be restored, so it is better to start your treatment as soon as you diagnose your illness.

The treatment of your condition depends upon the type of the glaucoma you have, how far it has progressed and how much damage has been done to your eye.

With the advancement in medical science there are a number of effective treatments available with you. So, here are some advanced methods by which you can stunt your condition.

Medications- an effective drug should have the following mechanism of action, it either should lower the level of Aqueous Humour production or should increase the drainage of the Aqueous Humour. So let us have a look at them

  • Eye drops- a rightly prescribed eye drops can do wonders in treating the disease.
  • Beta blockers- they lower the production of the aqueous humour production in the eye and do not bring any change to the size of the pupil. For example:- Betimol, Istalol.
  • Alpha-adrenergic agonish- these eye drops also decrease the intra-ocular pressure by augmenting uveoscleral outflow. For example: Aprodonidine, Brinonidine.
  • Carbonic anhydrase inhibition- decreases the production of the aqueous humour. For example: Dorzolamide (truspt).
  • Prostaglandin Analogs- these are the new types of hypotensive drugs which increases the outflow of the fluid into your eye.
  • Miotic eye drops– they lower the intraocular pressure by increasing the ciliary muscles tissues and improving the potency of trabecular membrane.

Oral Medications- if you think that merely relying on the eye drops will work then you are probably wrong. Apart from the eye drop medications you need to consume some oral medications that your doctor recommends.\

Surgery and other Therapy

  • Trabeculoplasty- this surgery helps to open trabecular meshwork and open angle.

-Implants

  • Drainage tubes- which stunts the fluid out of the anterior chamber or
  • By by-passing the meshwork and collecting system.

Lifestyles changes

  • Include a healthy diet
  • Exercise cautiously
  • Limit the consumption of caffeine
  • Frequently drink water and other fluids
  • Always sleep with your head elevated

Alternative medicines

  • Herbal remedies– like bilberry extract is known to treat glaucoma, further studies are needed to prove its effectiveness.
  • Relaxation techniques– medications and other calming techniques can help reduce the stress that may be one of the reasons for glaucoma.
  • Marijuana- it is known to have lowered eye pressure but not for too long, so it is not an ideal treatment.
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CBD for Glaucoma

A CBD or cannabidiol is one of the core compounds secreted by the cannabis plant, the other being THC or Tetrahydrocannabidiol, although both of them are the components of marijuana but they differ greatly in their properties. THC is a psychoactive drug that gets you high whereas many researches have found out that CBD acts as a natural healer and effectively treats many ailments without getting you high.

In fact the CBD infused products with less than 0.3 % THC have taken the world by storm with its much promising results in many medical healings. So looking at this overwhelming response from a large group of people on the efficacy of CBD, let’s see what all CBD has to offer in the treatment of Glaucoma and let’s find out whether it is beneficial for it through this article.

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Research in the filed of Glaucoma and CBD

Amongst all the great hype on CBD being a natural healer for the people suffering from various illnesses. The latest research on CBD as a potential treatment for glaucoma is quite conflicting, where some support CBD while there are others that warn people of its unpredictable and unreliable effects.

Glaucoma is the second leading cause of blindness globally according to the WHO. With almost no definitive cure for it, treating it in the early stages is the only option.

With advances in the medical sciences and seeing the progress and possible potential of CBD, the researchers are hoping to create medications from cannabinoids.

One study published in the international journal of pharmacology and biopharmacology in 1979, supported the fact that CBD could help treat Glaucoma, after carefully examining the effects on 16 patients with glaucoma mostly open-angle glaucoma. They have experienced a reduced intraocular pressure behind the eyes.

Another study reveals that the effects of CBD in decreasing the intraocular pressure were more promising and effective in patients with hypertension.

A 1971 study found out that that the psychoactive compound of the cannabis plant i.e. THC is a more viable and highly effective treatment for glaucoma and it is known to reduce 60-65% of intraocular pressure. But it comes with a downside, it will make you high and chances are that you might get physically and mentally addicted to the same.

A more recent, 2006 study suggested that a single 5 mg sublingual dose of CBD people actually experienced a reduction in the eye pressure. Significantly high dose of CBD around 40 mg had an opposite effect and it somewhat increased the eye pressure.

Apart from all the studies that give a green signal to CBD as a possible treatment for glaucoma, there are studies that show a bad deal about it, according to them CBD has more side effects than it reap benefits.

A study by Indiana University warned to not use CBD as a remedy for glaucoma. As the researchers found nearly 18% increase in the pressure when a few CBD infused eye drops were given to mice. So given this study and many other studies, a question arose as to whether CBD is the legitimate treatment option or may simply act as a potential risk factor for glaucoma.

In order to get the most benefits from CBD for glaucoma you have to take it after every 3-4 hours because of its short acting and this may result in a habit forming drug, so isn’t always a reasonable or effective treatment for glaucoma.

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How CBD has an effects on Glaucoma

The primary target area of the body where CBD interacts primarily is the endocannabinoid system (ECS), which affects virtually all the features of health, including pain inflection, immune response, managing anxiety and panic attacks and also dealing with inflammation.

Many CBD binding receptors and other cognate biosynthetic enzymes and cannabinoids like AEA and 2-AG are found in the ECS of the human body. Some of them are involved in the ciliary body tissue and other ocular tissues that regulate intraocular pressure. All these components play an important role in the endogenous signalling of both posterior and anterior eye. And when CBD effectively interacts with them it produces alteration in the eye pressure.

So, when CBD is applied to the eye in the form of eye drops, this causes a series of changes notably hyperemia, reduced tear production and the most important one is the reduction in the intraocular pressure.

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How can we use CBD for treating Glaucoma

CBD comes in varied products and each of them has different amounts of CBD, so special care should be taken while injecting them. They can be either applied, sprayed or you can even take them orally. All of them have vaso-relaxant, which may help to increase the ocular blood flow. The most common way to use them is by eye drops.

These also help to reduce the inflammation in the various parts of the eye and alleviate other symptoms such as nausea, vomiting and severe eye pain, which manifest due to glaucoma.

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Ways to use CBD products for Glaucoma

  • CBD OIL- the CBD oil comes in three types namely:- full-spectrum CBD oil, broad-spectrum CBD oil and CBD isolate.
  • EYE DROPS- these are the most common and mostly preferred form of medication for glaucoma. These need to be regularly on the doctor’s recommendations.
  • SUBLINGUAL- the sublingual application of THC may help to reduce intraocular pressure. THC lowers the IOP by 60-65% according to some studies.
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Benefits of using CBD for Glaucoma

Although CBD is not yet proven to provide a precise remedy for glaucoma or halt its full progression yet it provides many other benefits. As we know that glaucoma is a combination of eye diseases, so CBD may help in lowering and controlling the symptoms that arise because of glaucoma. For example:-

  • Many studies have shown that CBD, due to its analgesic, anti-nausea and anti-inflammatory properties, provides relief from unexpected and uncontrollable symptoms that accompany glaucoma.
  • It also provides the therapeutic alleviation of symptoms in glaucoma patients due to its anti-inflammatory property.
  • The vaso-relaxants components of CBD may help increase ocular blood flow.
  • Some research has found out that CBD can bring the production of peroxynitrite to a standstill, peroxynitrite is formed from a damaging chemical called glutamate, which is known to kill the neurons in the retina.
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Side effects of CBD

The short time use of CBD is known to show mild effects but the long term use can lead to some serious diseases like lung cancer and retarded mental health. Some of the side effects of using CBD are as follows:-

  • Conjunctival hyperemia
  • Less tear production
  • Light sensitivity and irritation to eyes.
  • Blepharospasm or uncontrolled eye movement
  • Shaking eyes.
  • Can reduce blood flow to the optic nerve which is already facing complications.
  • Since a glaucoma patient need 24-hours pressure control, so you need to give CBD for at least 8-10 times due to its short acting. The high use can be habit forming and can cause addiction.
  • The American Academy of ophthalmology, strictly asks people to not take CBD as a remedy for glaucoma as it may actually increase the intraocular pressure.
  • Increases paranoia.
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Dosage Recommendation

Every person’s biochemistry is different and they react differently to the same dosage given to many different people. So you should regularly monitor your dosage and take the advice of the doctor.

The effective CBD dose for most people is 25 mg/day and the dosage can be increased after a week’s usage to subside the strong symptoms, however this should be done under doctor’s recommendation only.

A 2006 study found out that 10-20 mm Hg was effective in lowering the intraocular pressure while 20 or more than that did not reduce the pressure, whereas an increases dosage of around 40 mm Hg actually increased the intraocular pressure and caused more harm than benefits.

An estimated 8-10 doses of THC is to given to glaucoma patient because of its low activity and to maintain a 24- hours pressure control in them. This may cause serious long term effects and possible risks, so a proper supervision has to be given to the amount of dosage that you intake.

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PROS and CONS

Pros
  • A low dose of CBD may lower the eye pressure in glaucoma patients.
  • It may help in treating the various symptoms that arise along from glaucoma, such as nausea and migraines.
  • CBD can reduce inflammation of the cornea and may reduce its pain inflection.
  • CBD may have therapeutic effects on glaucoma.
  • More positive outcomes in a near future.
  • Its availability in many forms

Cons
  • CBD may actually cancels out the eye-pressure lowering effects of THC.
  • A high dose of CBD may increase the eye pressure in the eye as proved by many recent studies.
  • There is unsanctioned supply of CBD products for medical use.
  • There is a limited research on the effects of CBD on glaucoma.
  • The CBD- based treatments and products face the problem of bioavailability.
  • Availability of CBD adulterated products in the market.

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