Drug Watch International
GLAUCOMA
Why Marijuana is not a Safe or Effective Treatment
What
is Glaucoma:
Glaucoma, a leading cause of blindness, in the United States, afflicts
nearly 2 million Americans, about 60,000 of whom are legally blind.
Open
angle closure glaucoma:
In the vast majority of cases this type of glaucoma is without symptoms.
It is associated with mild elevation of intraocular pressure that
produces chronic damage to the optic nerve.
Open angle closure glaucoma is treated medically with drugs that reduce
aqueous humor formation.
Acute
angle closure glaucoma:
This rare form
of the disease, which may include pain, blurring of vision, halos around lights,
etc., is treated with laser or
surgery.
Although
elevated intraocular pressure is a common symptom of glaucoma, nearly 20 percent
of those who have the disease do not experience elevated pressure.
For these the traditional screening tests may miss the diagnosis and,
since glaucoma patients "almost never have symptoms," damage will
continue to progress in their eyes.
Medical
treatment for Open Angle Closure Glaucoma:
Because
the level of pressure that causes damage varies from person to person a target
"normal" pressure must be determined for each patient and the
treatment carefully adjusted. "Daily
variations in pressure complicate the assessment of treatment, since eyes
affected by glaucoma tend to have larger fluctuations than normal eyes."
(New England Journal of Medicine, 328:1103,1993)
Prostaglandins:
These drugs are being developed to improve aqueous humor outflow and are
believed to "hold much greater promise for the hypotensive therapy of
glaucoma."
Beta
blockers:
At least four are marketed in the United States and being used successfully
in the treatment of intraocular pressure associated with glaucoma.
According to researchers there is "little motivation to develop new
inhibitors of aqueous humor formation since the market is relatively saturated
with such drugs.
In the
latest scientific evaluation of glaucoma treatment, as reported in the New
England Journal of Medicine, 328:1103,1993, marijuana was not mentioned as
having any role whatsoever.
What
about marijuana?:
The country's
leading ophthalmologists are "chagrined" and "disturbed" to
hear that claims are being made touting marijuana as a treatment for glaucoma.
Because of wide fluctuations in intraocular pressure, and a numerous
other factors which affect the course of this disease, doctors agree that using
marijuana as a treatment is likely to mask problems and increase the risk of
blindness.
William
T. Shults, M.D., recognized in the publication "The
Best Doctors in America," for his work in ophthalmology at the Devers
Eye Institute in Portland, Oregon, noted that alcohol can also lower intraocular
pressure if one has ingested enough to be intoxicated.
He added that no one would propose using alcohol for that purpose,
however, because of its many adverse side effects. Shults stated " I can
see no compelling reason whatsoever for the use of marijuana by patients with
glaucoma, and believe that to
propose such a use works a cruel hoax on the public and especially those with a
chronic ocular disease for which many other better treatments are currently
available."
Even
Judge Francis Young, the DEA administrative judge often quoted by advocates of
medical use of marijuana, stated that he found insufficient evidence to show
that marijuana is an accepted treatment
for glaucoma.
Reissued
by the Northwest Center for Health & Safety January 1995
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