The Effects of Smoking on Your Eyes

Why smoking-related eye ailments are rising in prevalence across the GCC  

By Dr. Ammar Safar, Consultant Ophthalmologist and Vitreoretinal Surgeon, Medical Director at Moorfields Eye Hospital

The World Health Organization (WHO) estimates tobacco use in the Eastern Mediterranean Region to be nearly 25%, compared to the worldwide prevalence rate of 22.7%. A number that is even higher when non-cigarette tobacco products like shisha and dokha are included. While these non-traditional tobacco devices are on the rise, so is the prevalence of smoking in the United Arab Emirates, as the country reigns in among the leading countries in the region in terms of Self-reported tobacco use. 

Most people are very aware that smoking in all forms can cause cancer, lung and heart disease, as well as many other chronic health ailments. But did you know that smoking is one of the most harmful habits for the eyes? A study by the British Medical Journal found that smokers are up to four times more likely to go blind in old age; however, many smokers are not aware of the risk. Below, I will discuss four eye-related risk factors that smokers and those frequently exposed to tobacco smoke should know.

Dry Eye Syndrome

Dry eye syndrome is a common condition, especially in the gulf area, where the dry climate can severely aggravate the eyes. Dry eye syndrome occurs when your eyes do not have enough amount, or the right kind of tears. Cigarette smoke is known to have over 7,000 chemicals, many of which can irritate and damage in the setting of dry eye syndrome. Symptoms of dry eye syndrome include burning sensation, scratchy eyes, redness, sandy sensation and severe irritation. Experts recommend that people prone to dry eye avoid smoking and contact with smoke all together as smokers are twice as likely to develop dry eye syndrome.

Cataracts 

A cataract is clouding of your eye’s naturally clear lens. It causes blurry vision and makes colours look dull, faded, or yellowish.  Cataracts are the leading cause of blindness and moderate visual impairment worldwide. Therefore, preventing cataracts carries the potential for significant health benefits, removing the financial and clinical burden of the disease. Thus, identifying risk factors for cataracts is important and may help to establish preventive measures.

If you smoke, you are at an increased risk of developing cataracts. Smoking alters the cells of the eye lens through oxidation and aids the build-up of heavy metals on the lens, contributing to the formation of cataracts.

Age-Related Macular Degeneration (AMD)

AMD occurs when a part of the retina called the macula is damaged. You lose your central vision and cannot see fine details, but your peripheral (side) vision stays normal. In some cases, certain medical treatments can help reduce AMD complications, but there is no cure. 

While age is the number one risk factor for the disease, smoking is a close second. Smokers are four times more likely to get this condition than non-smokers, and people who live with smokers are two times as likely to develop it as well.

Recent medical improvements have introduced a treatment for the severe form of AMD in the form of injections in the eye to restore vision loss. Research has proven that smokers are much less likely to respond to these injections than non-smokers.

Diabetic Retinopathy

Smokers who also have diabetes risk getting diabetic retinopathy. Diabetic retinopathy is when blood vessels in the eye are damaged. Smoking causes vasoconstriction or narrowing of the blood vessels, which reduces the blood supply to the eyes. The condition can lead to diabetic retinopathy, a disease characterized by symptoms such as blurry or distorted vision and possibly blindness. Treatment includes medication or surgery. Additionally, smoking raises blood sugar and can cause your body to become more resistant to insulin, which can lead to higher blood sugar levels. Uncontrolled blood sugar can lead to serious complications from diabetes, including diabetic retinopathy.

Smoking is the single most controllable risk factor that contributes to the development of many eye-related illnesses. The risk factors listed above are just a few of the many risks that smoking imposes. We advise patients to participate in programs to support them in their journey to quitting this harmful habit. Removing smoking from your lifestyle is one of the many healthy habits associated with optimal eye health. Quitting smoking will not only reduce the likelihood of patients developing eye issues throughout their lives, but it will also aid in the improvement of their overall lifestyle.