Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Phytocannabinoids, particularly those found in cannabis such as delta-9-tetrahydrocannabinol (THC), have been investigated for their potential to lower intraocular pressure (IOP), which is a key factor in the management of glaucoma. Early studies from the 1970s and 1980s demonstrated that both smoked marijuana and orally administered cannabinoids could produce short-term reductions in IOP. This effect is thought to be mediated through cannabinoid receptors (CB1) present in ocular tissues, which may influence aqueous humor production and outflow. However, the evidence supporting their clinical use is limited and problematic.

The primary limitations include the short duration of action (typically 3-4 hours), requiring frequent dosing, and the significant psychoactive side effects associated with THC. Additionally, most studies have involved small sample sizes, lacked rigorous controls, and did not assess long-term safety or efficacy. Current guidelines from major ophthalmological associations do not recommend phytocannabinoids for glaucoma treatment, largely due to these concerns and the availability of more effective and safer conventional therapies (such as prostaglandin analogs and beta-blockers). Other phytocannabinoids like cannabidiol (CBD) have not shown significant IOP-lowering effects and, in some cases, may even increase IOP.

In summary, while there is some scientific evidence that phytocannabinoids can lower IOP temporarily, the overall quality of evidence is low, and their use is not endorsed in clinical practice for glaucoma management.

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