Kent remembers his early days as a newspaper reporter when cigarette smoking was almost a tool of the trade. A thick cloud of smoke hung over the news room every day, and his eyes were red and stinging when he went home for the night.
Kent later became a smoker himself, almost out of self defense. And now, several decades later, his eyes are once again feeling the sting. Kent has age-related macular degeneration, one of many eye disorders that are smoking related.
The link between smoking and lung cancer was the first to be documented and publicized. Smoking is also a leading cause of emphysema and other lung disorders. It has been linked strongly to other cancers such as pancreatic, esophageal and bladder cancer. And it’s a major cause of heart disease.
The toxins in cigarette smoke, in fact, have a negative effect on virtually every organ of the body. So the link between smoking and vision should come as no surprise. Smoke does get in your eyes.
MACULAR DEGENERATION: Tar and other components of cigarette smoke have been identified as factors in the thickening of the retina and the deposits behind the retina that characterize the dry form of age-related macular degeneration (AMD).
Dry AMD, the least serious kind, progresses slowly, and about 10 percent of cases develop into the more serious “wet” form, which is characterized by leaking blood vessels that eventually can lead to severe loss of the central vision that is needed for driving, reading and detailed work. Nicotine in the cardiovascular system makes wet AMD worse, and patients are advised not to smoke and not to use nicotine replacement products.
One study published in the Archives of Ophthalmology [July, 2007] found a four-fold higher risk of macular degeneration in active smokers. Past smokers have a three-fold increased risk, and non-smokers exposed to second-hand smoke are also at high risk.
Age-related macular degeneration is the leading cause of blindness for Americans age 65 and over. And it’s a major reason to quit smoking.
CATARACTS: A number of studies have found an association between smoking and cataracts, with the risk increasing with greater smoking exposure and decreasing with smoking cessation. The large Cohort of Swedish Men with responses from 48,645 men found that present or past smokers were 21 percent more likely than those who had never smoked to need cataract extraction.
Smoking cessation resulted in a steadily decreasing risk, but some increased risk was found even in those who quit smoking two decades ago.
A cataract is a clouding of the lens of the eye that eventually can seriously impair vision. Although recently developed methods of cataract surgery can effectively restore sight, cataracts are still a significant cause of vision loss worldwide.
As with macular degeneration, one possible reason for the effect of smoking is the oxidative process and the tendency of smoking to neutralize or destroy antioxidants and other micronutrients that are essential to healthy eyes.
DIABETIC RETINOPATHY: Reduced blood flow is another major factor in eye disorders related to smoking.
Retinopathy is a complication of diabetes in which the blood vessels of the retina become damaged, leak fluid and blood, and grow scar tissue that distorts vision and ultimately can lead to blindness.
High blood sugar is the primary cause of diabetic retinopathy, but smoking contributes significantly by raising both blood sugar and blood pressure and damaging the walls of the tiny blood vessels. Oxygen in the blood is replaced by carbon monoxide.
According to one study, smokers were nearly three times as likely as non-smokers to develop advanced retinopathy.
AION, or anterior ischemic optic neuropathy, is an eye disease that creates sudden total loss of vision, usually without warning. Reduced blood flow to arteries in the eyes is the cause, and smokers have a 16-fold increased risk of developing AION and usually do so at a younger age–an average of 52 compared to 64 for non-smokers.
THYROID EYE DISEASE is a serious complication of Graves’ disease, an overactive thyroid. Eyes tend to portrude at first; then comes double vision and sometimes loss of vision.
The link between smoking and thyroid eye disease is strong. Graves’ disease patients who smoke are four times more likely than non-smokers to develop this complication and to suffer the most serious effects. And heavy smokers are seven times more likely.
Smokers are twice as likely to get Graves’ disease, compared to non-smokers. And some studies suggest that smoking creates an artificially high metabolism that may then fall and result in an underactive thyroid after smoking cessation. Combined with appetite changes, this may be one reason why persons who quit gain weight.
GLAUCOMA: Medical studies have not found any direct link between smoking and glaucoma, but doctors ordinarily advise glaucoma patients to quit smoking.
Glaucoma involves pressure inside the eye that becomes great enough to endanger the optic nerve. Because smoking generally causes blood vessels to contract, it is theoretically a reason for a buildup of pressure.
DRY EYE SYNDROME is a common condition that affects 10 percent of Americans younger than 60 and becomes increasingly common with age. Symptoms include irritation, itching, burning and sometimes, paradoxically, an excess of water in the eyes. Dry eyes lack the lubrication necessary to keep the eyes free of infection and foreign bodies.
Again, smokers have a higher risk of dry eyes, about double the risk of non-smokers. One study found that smokers who underwent refractive surgery to correct their eyesight had more frequent and more severe dry eye symptoms than non-smokers.
VISUAL ACUITY: Finally, if you are just interested in being able to read letters on the eye chart to pass your driving test, you will do better if you quit smoking or never start. Results of the Beaver Dam Eye study in Wisconsin found smoking to be one of biggest causes of visual impairment.
Clearly smoking has numerous negative effects on the eyes as it does on all organs of the body. It’s an irritant, a toxin, a cause of oxidation, inflammation, reduced blood flow through arteries, increased blood sugar and blood pressure.
Do you need one more reason to quit smoking?
REFERENCES:
Action on Smoking and Health, “Smoking and eye disease, May, 2014.
Diane Angelucci, “Smokers have unique dry eye conditions, study finds,” EyeWorld, August, 2004.
Troy Bedinghaus, O.D., “How does smoking affect your eyes?” About.com vision, updated May 19, 2014.
Mary Elizabeth Dallas, “Quitting smoking may cut cataract risk,” WebMD News from HealthDay, January 2, 2014.
“Graves’ eye disease or thyroid eye disease,” University of Michigan Kellogg Eye Center, reviewed by Raymond S. Douglas, M.D., Ph.D.
LarryHand, “Lifestyle choices may affect vision down the road,” Medscape Medical News, March 13, 2014.
Howard LeWine, M.D., “Effects of cigarette smoking on glaucoma,” Harvard Health Publications.
“Lifestyle changes may prevent dry eyes,” WebMD Health News, September 28, 2000.
Norra MacReady, “Smoking associated with cataract risk,” Medscape Medical News, January 6, 2014 (JAMA Ophthalmology, January 2, 2014).
Mary Shomon, “Cigarette smoking and thyroid disease,” About.com Thyroid Disease, updated June 3, 2014.
“Smoking and eye disease,” Better Health Channel, Vision Australia, 2014.
Aimee Surtenich, “How smoking harms your vision,” AllAboutVision, reviewed by Gary Heiting, O.D.
Dennis Thompson, Jr., “How smoking harms your vision,” EveryDayHealth, medically reviewed by Pat F. Bass III, M.D., MPH.
08/25/2014
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