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Smoking is already the leading preventable cause of death in the world: tobacco currently kills nearly 8 million people a year worldwide, more than 600,000 of whom are passive smokers. Although society is aware of the consequences of tobacco smoke on the body (cardiovascular diseases, respiratory diseases and even cancer), many people do not know that it can also affect the eyes and cause vision loss.

Toxins inhaled when smoking end up in the bloodstream and are distributed throughout the body, even in the eyes. This can lead to various eye problems, such as cataracts, dry eye, age-related macular degeneration (AMD), diabetic retinopathy, optic nerve problems, thyroid orbitopathy and uveitis. Many of these cases can even lead to blindness if not treated in time.

In addition, tobacco does not only affect the eye internally. Tobacco smoke can also affect the tissues around the eyes. It can cause puffiness under the eyes and disorders of the eyelids, such as irritation and inflammation, as well as yellow eyes due to the contact of smoke on the lens and other skin disorders that can affect the eyes.

What are the most at-risk groups?

Diabetics

One of the highest risk groups among smokers is diabetics. They are more likely to suffer from diabetic retinopathy, which occurs when the blood vessels of the eye are damaged. Smoking is also especially contraindicated for people who suffer from dry eye, since in addition to the lack of tears they suffer from, smoke increases dryness and eye irritation.

Pregnant women

Smoking is also especially contraindicated during pregnancy, as it can lead to premature birth and increases the chances of the baby suffering from a visual disorder known as retinopathy of prematurity. This disorder occurs when the blood vessels in the newborn’s retina have not developed properly, which could lead to retinal detachment and, in some cases, even blindness. In addition, it has been found that if the mother smokes during pregnancy, the baby is up to 5 times more likely to get meningitis, along with eye problems and infections.

Smoking during pregnancy may cause retinopathy of prematurity in the baby
Smoking during pregnancy may cause retinopathy of prematurity in the baby (CCO)

Children

Smoke exposure also affects children. Exposure to tobacco smoke in both active and passive smokers is one of the best known threats to eye health. However, a new study in Hong Kong has shown that as early as age 6, children can develop eye problems caused by smoke. It causes a thinning of the choroid (a layer of the retina filled with blood vessels) which, as a consequence, puts their vision at risk.

Tobacco smoke can cause eye problems in adults and children
Tobacco smoke can cause eye problems in adults and children (CCO)

What type of eye disorders cause smoking?

Tobacco smoke is made up of toxins that are harmful to the body, so inhaling it can cause serious health problems. Toxins pass from the lung into the bloodstream, spreading these toxic substances throughout the body, including our eyes. Smoking habit can increase the risk of suffering the following eye diseases:

  • Cataracts; at any age, smoking can increase the risk of cataracts. Cataracts, which is the pathology that appears most frequently in smokers, cause blurred and opaque vision and must be operated by surgery.
  • Dry eye ; this disorder happens when the eyes do not produce enough tears. Smoking may worsen the symptoms of this pathology since smoke causes eye dryness and irritation.
  • Age-Related Macular Degeneration (AMD); smoking increases the chances of suffering from this eye disorder. In this disease a part of the retina, the macula, is damaged and this causes a loss of central vision. There is no cure for this disorder that can cause serious visual disturbances. However there are treatments that can stop it from developing.
  • Diabetic retinopathy; diabetics who are smokers may develop retinopathy more frequently. This occurs when the blood vessels of the retina are damaged. Laser treatment, injected medication, or even surgery may be necessary to control the disease.
  • Problems in the optic nerve; smoking can cause problems in this nerve, which connects the eye with the brain, and can lead to blindness.
  • Thyroid orbitopathy ; thyroid orbitopathy is a disease that affects the thyroid gland and causes exophthalmos or bulging eyes. It has been shown that the prognosis of the disease is more severe in those OT patients who smoke.
  • Uveitis ; smoking can lead to uveitis, an inflammation that occurs in the middle layer of the eye called the uvea. As a consequence, the eye becomes red and causes pain and vision problems.
Smoking causes dry eyes, as well as other eye diseases such as AMD and cataracts.
Smoking causes dry eyes, as well as other eye diseases such as AMD and cataracts. (CCO)

What can we do to protect our eyes?

The good news is that after quitting smoking the risk of suffering from some eye disorders is considerably reduced.

In addition to quitting smoking or ventilating spaces where tobacco smoke has been present, there are some tips we can follow to protect our eyes:

  • Blink the eye frequently to prevent it from becoming irritated and drying out.
  • Protect the eyes of the sun using glasses with protection against UV rays.
  • Rest your eyes when you are performing an activity that forces them (reading, using screens, etc.).
  • Follow healthy eating habits that help maintain good visual acuity.
  • Keep a good eye hygiene.
  • Control blood pressure, cholesterol and blood glucose to detect possible symptoms of eye disorders.
  • See your ophthalmologist for an annual check-up.

In any case, stop smoking or stop being a passive smoker, may avoid the development of eye diseases in the long term.

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Medical content revised by - Last revision 02/03/2021

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