Eye Diseases Caused by Smoking

Smoking can cause certain eye diseases.
The main ones are cataract, glaucoma, and age-related macular degeneration.

In 2019 the FDA (US Food and Drug Administration) released 13 designs to be printed on cigarette packages.

Warnings about the health harm caused by smoking:

Eye diseases caused by smoking

Two main eye diseases caused by smoking

Of the 13 FDA tobacco illustrations,
two main ones related to ophthalmology are described:

• Age-related macular degeneration
• Cataract

WARNING: Smoking causes age-related macular degeneration, which can lead to blindness.
WARNING: Smoking causes cataracts, which can lead to blindness.

The photographs of a white man who appears to have a hypermature cataract and a man of color receiving an intraocular (intravitreal) injection are striking.

○ Smoking constricts blood vessels¹。

The blood vessels inside and at the back of the eye (retinal and choroidal vessels) are very thin, so they are easily affected.

Blood flow worsens
　↓
Retinal cells become short of oxygen
　↓
The cells become inflamed and harmful proteins (cytokines such as VEGF) accumulate inside the eye
　↓
Retinal disease develops²

Not only age-related macular degeneration, but also

•glaucoma
•diabetic retinopathy
• uveitis
• optic neuritis
• optic neuropathy
• thyroid eye disease
•dry eye

and others are also diseases caused by abnormalities of thin blood vessels.
For that reason, smoking similarly makes them worse.

Central serous chorioretinopathy, in which things suddenly look distorted

In daily practice I often see it heal just by quitting smoking for two weeks.

○ Smoking impairs the body’s antioxidant defenses.

• It damages antioxidants such as vitamin C, vitamin E, and beta-carotene, causing cells to oxidize³　
• Heavy metals such as cadmium, lead, and copper accumulate in the lens and further damage cells⁴　

For this reason, it raises the risk of cataract.⁵。

People with glaucoma or retinal disease often ask whether there is anything they should be careful about.

Many studies have been done, across all times and places, on food, drink, exercise, playing instruments, posture, and more.

(This week I wrote a piece:Tea and glaucoma）

No clear conclusion has been reached,

but smoking is not good.

is how I answer.

And, importantly:
Secondhand smoke harms children and the people who matter to you nearby.

WARNING: Tobacco smoke can harm your children.
WARNING: Tobacco smoke causes fatal lung disease in nonsmokers.

(Reference)

1. Moliterno, D.J., Willard, J.E., Lange, R.A., Negus, B.H., Boehrer, J.D., Glamann, D.B., Landau, C., Rossen, J.D., Winniford, M.D., Hillis, L.D., 1994. Coronary-Artery Vasoconstriction Induced by Cocaine, Cigarette Smoking, or Both. New England Journal of Medicine 330, 454–459. https://doi.org/10.1056/NEJM199402173300702

2. Bertram, K.M., Baglole, C.J., Phipps, R.P., Libby, R.T., 2009. Molecular regulation of cigarette smoke induced-oxidative stress in human retinal pigment epithelial cells: implications for age-related macular degeneration. American Journal of Physiology-Cell Physiology 297, C1200–C1210. https://doi.org/10.1152/ajpcell.00126.2009

3. Morrow, J.D., Frei, B., Longmire, A.W., Gaziano, J.M., Lynch, S.M., Shyr, Y., Strauss, W.E., Oates, J.A., Roberts, L.J., 1995. Increase in circulating products of lipid peroxidation (F2-isoprostanes) in smokers. Smoking as a cause of oxidative damage. N. Engl. J. Med. 332, 1198–1203. https://doi.org/10.1056/NEJM199505043321804

4. Rácz, P., Erdöhelyi, A., 1988. Cadmium, lead and copper concentrations in normal and senile cataractous human lenses. Ophthalmic Res. 20, 10–13. https://doi.org/10.1159/000266248

5. Ye, J., He, J., Wang, C., Wu, H., Shi, X., Zhang, H., Xie, J., Lee, S.Y., 2012. Smoking and Risk of Age-Related Cataract: A Meta-Analysis. Invest. Ophthalmol. Vis. Sci. 53, 3885–3895. https://doi.org/10.1167/iovs.12-9820