Dry Eye, Cataracts, Macular Degeneration: How Smoking Affects Eyes

Most people are well aware of the dangers smoking poses to lungs and the heart, but they don’t realize it also harms eyes. Additionally, using e-cigarettes carries risks too, though different from conventional cigarettes. “The ophthalmic risks from smoking are many and well-studied. Smoking is associated with an increased risk of developing various eye diseases, some of which can threaten vision. It can also worsen eye conditions caused by other factors,” explains Dr. Anastasios-I. Kanellopoulos, MD, Surgeon-Ophthalmologist, founder and scientific director of the LaserVision Institute, Professor of Ophthalmology at New York University. The effects of smoke and its chemicals on sensitive eye structures include the lens responsible for focusing light, the retina containing light-receptive cells, and the macula, the most sensitive part of the retina. Specifically, smoking is linked to dry eye syndrome, where eyes fail to produce enough or quality tears. Smoking exacerbates dryness, increasing irritation, burning sensations, and redness. Smokers are also at higher risk for certain eye diseases like cataracts and age-related macular degeneration. Smokers have two to three times greater chances of developing cataracts compared to non-smokers. They are four times more likely to develop age-related macular degeneration, occurring earlier than expected. Vaping introduces different risks. E-cigarette solutions often contain higher nicotine concentrations than traditional cigarettes. While not producing tar or carbon monoxide, they contain chemicals with known and unknown effects on eyes. Vaping may disrupt tear film stability, causing dry eye, increase cataract risk, reduce blood flow to the eyes, and cause inflammatory responses in corneal epithelial cells. Dual users of cigarettes and e-cigarettes experience more severe eye problems such as blurred vision, dry eye, redness, eye pain, light sensitivity, and headaches. Even infants exposed to maternal smoking during pregnancy face serious eye issues like retinopathy of prematurity, potentially leading to permanent vision loss or blindness. Avoiding smoking, vaping, and exposure to secondhand smoke is the best investment for long-term eye health.