Some studies indicate that consumption of cannabidiol (CBD) helps to significantly reduce intraocular pressure. This is one of the reasons why the small molecule derived from hemp is increasingly attracting the interest of researchers seeking an effective treatment for glaucoma, an eye disease that can lead to blindness.

Here's how it really is.

Glaucoma: definition, symptoms and treatments

To understand why CBD may be a potential treatment for glaucoma, it's important to know the underlying mechanisms of this disabling eye condition.

What is glaucoma?

Glaucoma is a group of eye diseases that affect the optic nerve, leading to vision loss. It is one of the leading causes of blindness worldwide.

There are several types of glaucoma, including :

Open-angle glaucomaOpen-angle glaucoma is the most common type of glaucoma, also known as chronic glaucoma. It is characterized by insufficient outflow of aqueous humor from the eye, leading to a progressive increase in intraocular pressure;
And angle-closure glaucomaless common, is generally caused by a sudden blockage in the outflow of aqueous humor, causing a rapid rise in intraocular pressure and rapid loss of vision.

Glaucoma is one of the most common eye diseases. It affects millions of people worldwide, although almost half of them are unaware of it. In most cases, glaucoma is a disease that progresses a disease that progresses silently. The risk of developing glaucoma increases with age, and people over 60 are more likely to be affected.

What causes glaucoma?

As we have just seen, the optic nerve damage that characterizes glaucoma is caused by an increase in intraocular pressure due to a disruption in aqueous humor flow.

However, this is not the only cause. In fact, some glaucomas occur despite normal eye pressure. Some studies suggest an underlying neurological problem, notably axonal damage to the neurons involved in vision.

Researchers are currently investigating other possible causes, but so far it seems that several risk factors such as heredity, age and certain diseases (diabetes, Alzheimer's) contribute to the development of the disease.

What about treatments?

Treatment of glaucoma is primarily aimed at reducing intraocular pressure to slow or prevent progression of the disease, thereby minimizing damage to the optic nerve. Treatment varies according to the type and severity of glaucoma.

Eye drops are often the first option. They contain drugs that reduce the production of aqueous humor or promote its drainage;
Laser surgery, if eye drops are not effective or in the event of late treatment. There are several procedures, but most often the operation consists of creating a small opening in the eye to facilitate drainage of the aqueous humor;
Implantable devices, such as drainage valves, can be used to regulate intraocular pressure by promoting drainage of aqueous humor.
In some cases, doctors may prescribe oral or injectable medication to control intraocular pressure.

These treatments are generally reserved for situations where other methods have proved ineffective.

Potential benefits of CBD on glaucoma

An article published in 2004 in the British Journal of Ophthalmology [1] explains why cannabinoids such as CBD are interesting candidates in the search for a treatment for glaucoma. The authors draw on a number of preclinical studies carried out in recent years.

Here's an overview of what you can read in this famous article.

Reduced intraocular pressure

A study [2] carried out in the early 1970s showed that cannabis consumption significantly reduced intraocular pressure (by between 25% and 30%).

Although this action is short-lived (between 3 and 4 hours), and despite an observed habituation (no effects in habitual users), these preliminary observations form the basis of all research conducted to date on the link between cannabinoids like CBD and glaucoma.

With the discovery of the endocannabinoid system in the early 90s, the mechanisms of action of cannabinoids in the human eye became a little clearer, although they are not yet fully understood.

Indeed, studies [3] have highlighted the presence of CB1-type endocannabinoid receptors in ocular tissue, in the retina.

Extensive research has also shown that these receptors are able to act on intraocular pressure by regulating aqueous humor production. Indeed, topical administration of a synthetic cannabinoid in glaucoma monkeys showed an 18% reduction in aqueous humor.

While these results are interesting, according to the researchers, this percentage indicates that other mechanisms are undoubtedly at play. In this respect, studies carried out on rabbits [4] suggest that cannabinoids, and THC in particular, may act on the dilation of blood vessels in the eye.

Finally, it is interesting to note that CBN and CBG are also being studied. Animal experiments [5] have shown that these two cannabinoids, when administered topically, can also significantly reduce intraocular pressure.

Neuroprotective properties

Blindness caused by glaucoma is the result of damage to the neurons involved in retinal function. In this respect, the neuroprotective properties of cannabinoids, and CBD in particular, are particularly interesting.

Through its action on the endocannabinoid system, CBD is involved in the regulation of many key functions, including those related to neuronal health. Indeed, several studies suggest that CBD has neuroprotective properties through certain mechanisms, including :

Reduces inflammation in neurons thanks to its regulatory action on the immune system;
Control of oxidative stress (responsible for apoptosis, the death of neurons) thanks to its antioxidant properties;
And finally, its ability to modulate neuronal excitability.

Indeed, the scientific community is closely studying the neuroprotective potential of CBD, particularly in the treatment of epilepsy and neurodegenerative diseases such as Parkinson's and Alzheimer's.

CBD treatment for glaucoma: limitations and prospects

These studies are all very encouraging. Indeed, it seems that cannabinoids are capable of acting on the main sources of the disease, namely intraocular pressure and the death of vision-related neurons.

However, it's worth noting that no single study has examined the effects of CBD on glaucoma in isolation. Indeed, it is the effects of cannabis, which contains other cannabinoids (THC, CBG, CBN, etc.) as well as terpenes, that are being studied. This suggests a first challenge, that of circumventing the intoxicating effects caused by THC. In this respect, therapeutic cannabis strains (low in THC and rich in CBD) may offer a solution.

But there are many other questions, such as dosage and route of administration. Indeed, some studies suggest that excessive cannabis consumption can lead to an increase in intraocular pressure, which in turn can aggravate the disease. Cannabinoids are also hydrophobic, making them difficult to administer topically.

In conclusion, CBD is not currently indicated for glaucoma. Consult your ophthalmologist if you experience vision problems.

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