Smoking and your eye health

Smoking contributes to a multitude of health problems, including stroke, high blood pressure, cancer and heart disease. However, many people are unaware of the toxic effects of smoking on your vision and eye health.

Cornea/Tear film: Increased risk of Dry Eye Syndrome
- Symptoms: Burning, itching, redness, tearing, foreign body sensation and intermittent blurry vision.

Extraocular muscles (EOM – six muscles that control the eye): increased risk for Graves’ Disease.

Symptoms: Stare due to eyelid retraction, redness, irritation, light sensitivity, double vision, EOM restriction, increased eye pressure
Conjunctiva: Increased risk of conjunctivitis (pink eye)
- Symptoms: Pink eye, burning, stinging, itching, swollen eyelids, light sensitivity
Lens: Cataracts. Risk >3x vs non smokers.
- Symptoms: blurred vision, difficulties with night driving (glare and halos)
Optic Nerve: Increased risk and progression of Glaucoma, Toxic Optic neuropathy, ischemic optic neuropathy, increased risk of progression and relapse or optic neuritis.
- Symptoms: visual field defect, pain, blur (or loss) vision, color deficiency.
Retina: Increased risk and progression of diabetic retinopathy and age related macular degeneration. Risk of macular degeneration in smokers is 2-3x more than non smokers.
- Symptoms: Loss of vision, distortion in vision.
Refractive changes: Research shows relationship between child’s myopia and history of maternal (mother) smoking during child’s life and pregnancy and history of paternal (father) smoking.
women smoking during pregnancy are more likely to give birth prematurely, putting the newborn at potentially blinding disease called Retinopathy of prematurity.

The toxic effects of smoking are caused by decreased flow to blood to the vessels of the eye, increased formation of clots within these blood vessels and cell damage from free radicals. However studies have shown a dose dependent relationship between tobacco use and its health side effects, therefore, these diseases (risk of) will likely decrease after smoking cessation. Some ocular conditions related to tobacco smoking have no cure, and therefore it is crucial to realize the importance of smoking cessation.

References:

‘Age-Related Eye Disease Study 2 Research Group. Lutein + zeaxanthin and omega-3 fatty acids for age-related macular degeneration: the Age-Related Eye Disease Study 2 (AREDS2) randomized clinical trial. JAMA. 2013 May 15;309(19):2005-15.

‘ Asensio-Sánchez VM, Gómez-Ramírez V, Morales-Gómez I, Rodríguez-Vaca I. Clinically significant diabetic macular edema: systemic risk factors. Arch Soc Esp Oftalmol. 2008 Mar;83(3):173-6.

‘ Caban-Martinez AJ, Davila EP, Lam BL, Dubovy SR, McCollister KE, Fleming LE, Zheng DD, Lee DJ. Age-related macular degeneration and smoking cessation advice by eye care providers: a pilot study. Prev Chronic Dis. 2011 Nov;8(6):A147.

‘ Krishnaiah S, Vilas K, Shamanna BR, Rao GN, Thomas R, Balasubramanian D. Smoking and its association with cataract: results of the Andhra Pradesh eye disease study from India. Invest Ophthalmol Vis Sci. 2005 Jan;46(1):58-65.

‘ Iyer JV, Low WC, Dirani M, Saw SM. Parental smoking and childhood refractive error: the STARS study. Eye (Lond). 2012 Oct;26(10):1324-8

‘ Lawrenson JG, Evans JR. Advice about diet and smoking for people with or at risk of age-related macular degeneration: a crosssectional survey of eye care professionals in the UK. BMC Public Health 2013;13:564.

‘ Lin P, Loh AR, Margolis TP, Acharya NR. Cigarette smoking as a risk factor for uveitis. Ophthalmology 2010;117:585- 90.

‘ Macsai MS. The role of omega-3 dietary supplementation in blepharitis and meibomian gland dysfunction (an AOS thesis). Trans Am Ophthalmol Soc. 2008;106:336-56.

‘ Physician behavior and practice patterns related to smoking cessation summary report. Washington (DC): American Association of Medical Colleges; May 2007.
http://www.aamc.org/workforce/smoking-cessation-summary.pdf.

‘Timothy CO, Nneli RO. The effects of cigarette smoking onintraocular pressure and arterial blood pressure ofnormotensive young Nigerian male adults. Niger J PhysiolSci 2007; 22:31–35

‘US Department of Health and Human Services. Agency for ¢ Healthcare Research and Quality. Clinical Care Guideline. Treating

‘ Vingerling JR, Hofman A, Grobbee DE, de Jong PT. Age-related macular degeneration and smoking. The Rotterdam Study. Arch Ophthalmol. 1996 Oct;114(10):1193-6.

https://www.aao.org/eye-health/tips-prevention/smokers