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Glaucoma Treatment: Marijuana, Weed, CBD & THC

glaucoma and weed

Marijuana, CBD and THC 

The biggest fad of this century is marijuana, CBD and THC use. There are some health benefits to using these drugs and derivatives. So, the question is what are the effects on our eyes and can they help me see better. First and foremost, there is no drug out there that will help you miraculously see clearer and let you stop wearing glasses. There are treatments and surgeries for this, and I can get more into that later. 

There are a few side effects that marijuana has on the eyes and it becomes more of a concern when a patient is diagnosed with glaucoma. Glaucoma is a disease that damages your optic nerve and eventually leads to peripheral vision loss (your side vision). It is the leading cause of blindness in the United States. This is a disease that you may not notice at first because your brain will fill in the “missing” spots of your vision by using visual cues in the environment.

 There is no cure for this disease, but optometrists can help slow down the amount of damage it can cause. Treatment of glaucoma involves lowering the pressure of your eye using topical medications such as latanoprost or timolol. There are multiple studies involving marijuana that have suggested that it can help lower the pressure of your eye while others have suggested otherwise. 

Now, this does not mean you should go to your nearest optometrist and attempt to get a prescription for marijuana because let me tell you right now. That ain’t gonna happen. 

Optometrists are not legally allowed to prescribe you marijuana because the ocular benefits have not been proven. The results are variable and unpredictable and there is no real way for us to monitor the condition and progression of the disease. 

If you are planning to smoke marijuana, One hit would also do nothing to help decrease pressure. Depending on the dosage and potency, you would have to smoke every day and about 8 to 10 times a day to see any effects. Basically, you need to be a full-time stoner. Or a high functioning one that can hold down a full-time job at the same time. 

The other problem is that with continued use, your heart rate will slow down and decrease your blood pressure. This is a good thing in some cases but with glaucoma its bad because we’re cutting down the amount of blood that reaches a damaged optic nerve. This doesn’t mean we won’t stop you from finding your own source and taking it. By all means, take a hit and relax because god knows we all need a break. 

Chicago eye doctor

A word of caution to any self-diagnosing users. Recent studies have suggested that the use of CBD oil can actually increase the pressure in your eyes. This is the exact opposite of what we are trying to do. The higher the pressure is, the more damage there is to the optic nerve. Some studies have found that use of THC may help decrease pressures up to 30%. These results are not always consistent and need to be explored further. Bottom line is you should probably shouldn’t be using marijuana and its derivatives to treat ocular diseases because there hasn’t been any solid scientific evidence that supports its use. However, that does not mean you can’t use these substances! Just do so in moderation and caution. 

What is emmetropia, myopia, and hyperopia?

What is emmetropia, myopia, and hyperopia?

Emmetropia, or what optometrists refer to as the perfect eye, is an eyeball that can see 20/20 at both distance and near with no assistance from glasses. Light that enters this eye will land perfectly on the retina allowing patients to see clearly at both distance and near. This is the eyeball that we all wish we had but unfortunately not all of us are that lucky. Every eyeball from here on out will be compared to an emmetropic eye because they are “perfect”.

Myopia, or more commonly known as nearsightedness, is condition in which we can’t see that well at distance, but we can see fairly well at near (as long as you don’t have a super high prescription). This can be for one of two reasons. In some people our eyes are just too damn long. They never stopped growing and now when light enters the eye, it doesn’t land on the retina like it normally would in an emmetropic eye, it lands in front of the retina. Since the retina is further back, optometrists prescribe minus lenses that will diverge the light a little further to allow it to land on the retina. The other reason why a person might be myopic is because they might just have too much refractive power in their eyes. Basically, light will still land in front of the retina even though their eyes are the same length as the “perfect” eye. To correct this eye doctors will still use minus lenses to cancel out the extra plus power the eye is creating.

Hyperopia, or farsightedness, is a little more of a tricky situation. Depending on high your prescription is, you might be able to see clearly at both distance and near or not well at either distance. The reason for this is because our eyes have a built-in focusing system that eye doctors call the accommodative system. To see up close we need a little bit of plus power. Anatomically, we have a lens that controls where light is focused in our eye. The lens is the key factor in this focusing system. To see up close, the muscles attached to our lens will contract and change the shape of the lens. This gives us the little bit of plus power we need to see up close. However, this is one of the big reasons why hyperopic with small prescriptions do not adapt well to glasses or don’t even know they need glasses until later on in life The accommodative system will make up for the small amount of plus power a hyperopic patient needs so that they can see clearly up close and far away.

Patients that need more plus power than our lens can give us face a different issue. These patients usually cannot see well at distance or up close because of where light entering the eye lands. Similarly to myopic patients, there are hyperopic patients can have a different sized eyeball. In comparison to an emmetropic eye, a hyperopic eye is too short. Basically, these eyes stopped growing a little too early. When light enters the eye, it will land behind the retina creating that blur at distance and near. To correct this, patients will be prescribed plus lenses to converge the light entering the eye and bring it forward to land on the retina. There are also patients that have the ideal eye length like an emmetropic eye, but they just have too much power in their eyes. Again, to correct this, optometrists will prescribe plus lenses to cancel out the extra minus power in the eye.

What is amblyopia or lazy eye?

What is Lazy eye?

Amblyopia, or more commonly known as lazy eye, is a decrease in vision of the eye(s) without detectable health problem. There are two types of amblyopia: strabismic and refractive. Strabismic amblyopia is when there is a problem in our binocular vision (how well your eyes can work together). When the two eyes are not directed simultaneously to look at an object that a person is looking at, then only one eye will receive information about what it is seeing. The other eye decides to be “lazy” and starts to move in any direction it thinks is comfortable. This lazy eye creates what optometrists call a strabismus (a misalignment due to muscle imbalance in the eyes). This becomes a real problem for younger kids because they are still growing and so are their eyes. With one eye hanging off to the side and doing its own thing, there won’t be normal visual development.

Another reason why a person could amblyopia is because a person has a very large difference in prescription between both eyes. This is called a refractive amblyopia. In these situations, people can normally keep their eyes lined up and pointing in the right direction. Of course, this isn’t your typical lazy eye appearance, the real problem is happening behind the scenes. Often a person who has amblyopia due to prescription differences suppresses an eye. Suppression is fancy eye doctor terminology for the brain blocking out the vision coming in from one eye and relying only on the other eye. Basically, you think you’re seeing out of both eyes, but your brain is only using one. This becomes a problem for a patient’s depth perception. We need both of our eyes to give us the binocular vision required to see depth.

Now you might be wondering how in the world do optometrist’s treat this condition. There are a couple options out there! For both types of amblyopia eye doctors offer vision therapy or VT for short. These appointments will consist of a series of exercises that will help you to work out those muscles in your eye to strengthen them. After the appointment you will often be assigned with homework (I know who does homework anymore?? But I promise it will all pay off in the end!). These assignments are usually just a repeat of what you did with the doctor so you can exercise your muscles on your own time.

For strabismic amblyopia there are a couple more options out there. If vision therapy is not for you and all you want are glasses, optometrists can prescribe prism in your glasses. (Warning! This next part is a long explanation of the physics of prisms. So, if you don’t care about the math that is disguised as science, skip ahead! I’ll let you know when to start reading again. ☺️) Prisms are optical devices that help shift your visual perception. Prisms are shaped like pyramids, so just picture one in your head as you keep reading. At one end of the prism is the apex (the top of the pyramid) and the other end is the base (the bottom of the pyramid). Light that enters the prism (from the faces of the pyramid) gets refracted towards the apex. Basically, an image in your visual field will get shifted to the apex of the prism. This will also move your eye because it will follow the image that the prism has shifted. To put this in perspective, let’s say your right eye is swinging out to the side. We want the eye that is sitting out to move inwards. When we place a prism (base out in this case) in front of that eye, it will send the image inwards, towards the nose, and the eye will also swing back towards the nose.

(End of unnecessarily long basic science explanation for the nerds like me! Continue reading from here please!)

With the prism in place it will help with the cosmetic appearance of your eyes by helping them look a little more aligned. The other option is surgery. This is more of a last resort option if VT or the prisms are not the ideal choice for you. In the event you would like surgery an eye doctor can refer you out to an ophthalmologist that specializes in strabismic surgery.

Now for refractive amblyopia, the treatment options are a little simpler. Our first option is vision therapy of course but the other options (and a lot of you out there might like to hear this) is contact lens! Yes, as optometrists we do encourage contact lens wear as long as you are responsible with them. Contact lens are a great option for a few reasons. With a large difference in prescription between the eyes there will be a cosmetic effect on our eyes when wearing glasses. Patients that are higher myopes (nearsighted) are prescribed lenses that will make their eyes look smaller to other people. Patients that are higher hyperopes (farsighted) are prescribed lenses that will make their eyes appear larger. With contact lenses there, we can eliminate the magnification difference and enhance the cosmesis effect for the patient. The other benefit for contact lens is that any visual distortions from the lens in glasses will be eliminated. This includes the magnification difference when a patient is looking at an object and any other lens distortions in the periphery.

If you think you have amblyopia or if you know you have amblyopia and would like to talk more about these treatment options, contact your nearest optometrist! (Preferably Dr. Toader if you’re from the Chicagoland area because she also offers vision therapy at her office! ☺️)

Can you fix macular degeneration?

Blog | Ophthalmology & Macular Degeneration Treatment

Can you fix macular degeneration?

Age-related macular degeneration is included in the group of pathologies defined as degenerative maculopathy. In particular, the age form, most often found especially in women, appears in the sixth decade of life in both eyes, although not always in the same degree of severity.
It affects the yellow spot, in other words, the part of the retina that is responsible for the clarity of vision.
The patologic picture is quite complex and includes various changes: the formation of drusen, neovascularization of the retina, detachment of the pigment epithelium, which can occur separately or at the same time and lead to blindness in case of late detection and treatment.
A test to identify the evolutionary stage of degeneration and classify the type of damage is fluorography and OCT. The first is the intravenous administration of a contrast agent and the observation with the help of a retinograph of the passage of the substance through the vessels and layers of the retina and the corresponding changes.
The most appropriate therapy at the global level is intravitreal administration of Anti VegF (vascular endothelial growth factor) drugs, such as Avastin, Lucentis, Macugen, etc., that act against neovascularization, and therefore against the main complications of macular degeneration in its “raw” form .

Treatment of age-related macular degeneration
Through sight, a person receives most of the information. Gradually, however, visual acuity decreases, and approximately 20% of people over 50 years of age have age-related macular degeneration (AMD). The cause of this disease is dystrophy of the macula, the central and most important part of the retina. Namely, central vision is required for work, reading, driving a car, it affects the ability to work in mature and old age. The price of his loss is very high.

Forms of AMD
Forms of age-related macular degenerationIn ophthalmology, there are two forms of age-related macular degeneration – dry and wet. The most common (85–90% of cases) is the dry form of AMD, in which yellowish spots appear in the area of ​​the macula – drusen. Expanding, drusen provoke an inflammatory process with an increase in the number of pathological vessels. Next, scarring of the tissue occurs, leading to a deterioration in central vision, up to its complete loss. Therefore, timely diagnosis and treatment are so important.

However, this form is less severe than wet, in which the disease develops rapidly. The newly formed vessels are inferior and fragile. Leaking from them, lymph and blood cells accumulate under the retina, damaging the photoreceptors. Without treatment of the wet form of AMD, loss of central vision occurs.

Risk factors for age-related macular degeneration
Among the main risk factors for the development of AMD are such as

– age over 50 years;
– genetic and genetic predisposition;
– Belonging to Caucasians;
– history of cardiovascular diseases;
– light iris;
– cataract;
– female;
– smoking;
– unhealthy diet and high body weight;
– effects on the retina of ultraviolet radiation.
The symptoms of AMD
At first, the symptoms of WYD are hardly noticeable, especially if only one eye is affected. Over time, a blur appears in the center, which then darkens. Colors become difficult to see, objects appear to be misty and vague. Contrast decreases, it becomes difficult to look in bright light and to do work that requires a good view at close range.

Modern methods of diagnosis of patients with AMD
You can check the quality of vision even at home with the Amsler test. Normally, a person sees a black dot located in the center of the grid. If there are problems, the grid lines are distorted, the point spreads and turns into a spot. This is a serious reason to contact an ophthalmologist.

For the most accurate diagnosis of changes in the macula using optical coherent tomography, which allows to identify the earliest manifestations of age-related macular degeneration. Also, experts use fluorescent angiography of the fundus. Both of these methods allow you to confirm the diagnosis, clarify the stage of the disease and determine the optimal treatment strategy.

Treatment Forms of AMD

Treatment of various forms of AMD
To date, the most effective treatment method is the introduction of drugs that inhibit the growth factor of the newly formed eye vessels.

Medications for the treatment of age-related macular degeneration
Medications for the treatment of AMD in Belarus are “Eilea” and “Lucentis”. Both are inserted into the vitreous of the eye and are designed to stabilize the visual function and prevent further damage to the macula.