Glaucoma refers to a group of five diseases
which result in damage to the optic nerve and vision loss.
A major risk factor of glaucoma is increased pressure in the eye.
Ophthalmologist treat glaucoma by lowering the intraocular pressure with medications,
or surgical interventions if necessary.
There has been an ongoing interest in the use of
medical cannabis for glaucoma since the 70s,
when reports that smoking marijuana lowers intraocular pressure began to emerge.
There is clear evidence,
as expressed by numerous studies,
that smoked and orally administered cannabis can lower
intraocular pressure by some 25 percent in approximately two-thirds of patients.
There are a couple of serious drawbacks, however.
First, reduced intraocular pressure might be associated to lower blood pressure,
a known effect of cannabis consumption,
which may reduce blood flow to the optic nerve and damage it.
Second, the effect is only temporary,
and typically lasts for no more than 3-4 hours,
no matter the dose.
In other words, in order to achieve constant lowering of intraocular pressure,
cannabis has to be consumed every 3-4 hours around the clock.
These drawbacks raise obvious concerns which led
the American Academy of Ophthalmology to state in
2014 that it does not recommend
marijuana or other cannabis products for the treatment of glaucoma.
Epilepsy at childhood usually begins in the first few years of
life and is frequently characterized by seizures that can be resistant to treatment.
If severe, these can delay child development,
and significantly impair quality of life of both the child and the family.
Public and professional interest in the use of medical cannabis for
the treatment of childhood epilepsy has grown in the past few years.
A recent survey from Stanford University
reports a dramatic decrease in the number of seizures from
cannabidiol-enriched cannabis in 16 of 19 children with resistant epilepsy;
80-100 percent reduction was reported by half of the parents.
Children showed increased alertness,
better mood, and improved sleep with minimal side effects.
Due to the absence of psychoactive effects in cannabidiol,
the use of cannabidiol-enriched cannabis has major advantages,
and notably in children.
A new CBD product known as a Epidiolex,
has been developed for the treatment of severe intractable epilepsy.
And initial reports of its use in
137 children shows an overall 54 percent reduction in seizures' frequency.
At three months, nine percent of the children were seizure-free.
Based on these remarkable results,
placebo controlled trials are now conducted.
Although not yet formally recognized,
it appears that medical cannabis containing
high CBD and low THC is more effective for child epilepsy.
If officially proven effective,
this is great news for young children with epilepsy,
because of the lack of psychoactive properties of CBD.
Elon EisenbergProfessor of Neurology and Pain Medicine
