Smoking tobacco introduces toxic compounds that may cause inflammation in the eyes and the body, and nicotine also raises blood pressure and heart rate, which may constrict the tiny blood vessels in the eye. This is linked to the possibility of fluid accumulation in the retina, damage to the optic nerve, and increased risk of glaucoma and age-related macular degeneration.
“Even after people stop smoking, the retinal basement membrane remains damaged, and the very tiny blood vessels there remain constricted,” said Greg Feinerman, board-certified eye surgeon and owner of Feinerman Vision. This may lead to the accumulation of waste under the retina, with the possibility of “dry macular degeneration” developing into the more serious “wet macular degeneration,” in addition to current smokers may be less responsive to macular degeneration treatments.
Data indicate that genetics plays a role in up to 70% of cases of age-related macular degeneration, while smoking increases the risk in those with certain genetic traits. According to the Macular Degeneration Society, one-third of cases are caused by a combination of genetics and smoking. “You can’t control your genes… but regardless of your basic genetic makeup, it makes sense to reduce or quit smoking as much as possible,” said Tariq Mohamed, an assistant professor and vitreoretinal surgeon at the University of Maryland.
Handling cigarettes may also be associated with superficial damage to the eyes, as Jackie Bowen, president of the American Ophthalmological Association, explained that tar and nicotine on the hands may contaminate contact lenses, causing a burning sensation and dryness, and with continued irritation, the risk of “cataracts” may increase, in addition to dry eyes and “uveitis,” or redness and inflammation of the iris.
The effect extends to passive smoking, as exposure to smoke and touching cigarettes may irritate the eyes, and a study from Hong Kong indicated that young children exposed to passive smoking showed signs of damage to the part of the eye that supplies blood to the retina, with a noticeable effect even when passively exposed to “one cigarette a day.” It has also been reported that smoking during pregnancy may transfer toxins to the placenta and raise the risk of eye disorders in the fetus and infant, including strabismus and incomplete development of the optic nerve. In addition, premature birth may increase the possibility of vision problems.
As for electronic cigarettes and vaporizers, they rely on heating and vaporizing a liquid containing nicotine and flavors, and nicotine in them may raise blood pressure and heart rate, which is harmful to eye health, while a 2017 study concluded that some of their materials may increase “oxidative stress” and inflammation. Another study reported that the use of these products is associated with an increase in the chances of moderate to severe eye dryness and a decline in the quality of the tear film compared to healthy non-smokers, noting the possibility of the production of “formaldehyde,” which is known as an eye irritant and possibly a carcinogen. In contrast, the link between cigarette smoking and eye disease is said to be “well-studied”, while the long-term effects of e-cigarettes are less clear as they are newer products.
With regard to mitigating the effects, quitting smoking was considered the “best first step,” emphasizing that stopping at any age can significantly reduce the risk of infection, in addition to the CDC recommending regular eye examinations for former or current smokers, because age-related macular degeneration may appear without clear warning symptoms. (verywellhealth)
