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Do your eyes age faster if you are a smoker?

by | Feb 1, 2025 | Manuscripts | 0 comments

Mohammad Akif Akram, B.Optom

Fellow Optometrist, Dr. Shroff’s Charity Eye Hospital, New Delhi, India

 

Tobacco smoke is a hazardous mixture of over 5,000 chemicals, many of which are toxic and potentially damaging to the eyes.(1) Smoking tobacco (cigarettes, cigars or pipes) can cause heart & lung disease, cancer and many other serious health problems. Did you know smoking can also be very harmful to your eyes?(2) This blog discusses some of the major conditions that age your eyes more quickly if you’re a smoker: Age-related Macular Degeneration, Dry Eyes, Cataracts, Diabetic Retinopathy, Uveitis, Thyroid Eye Disease, and CSR.

In other hand, smoking during pregnancy can increase the risk of ROP (Retinopathy of Prematurity) in newborns. (3)

Age-related Macular Degeneration (AMD):

In AMD macula is damaged,which affects central vision and becomes blurred and distorted. Although peripheral vision is not affected. Smoking causes oxidative stress, damages the retina and reduces blood flow in the eye tissue.(4) This leads to oxygen deprivation in the macula which can result in tissue death.(5) Smoking increases the risk of developing AMD, which is develop very earlier in smokers, but those have quit smoking 20 years back or more have roughly the same risk of developing AMD as non-smokers.(6) Smokers who have a family history of AMD or carry genetic variants associated with the condition are at an even higher risk of developing AMD.(7)

Cataract:

A cataract is a cloudiness of your natural crystalline lens of your eyes. If you are a smoker there is increased risk of early cataract and it increased with the amount smoked.(8) Although the exact mechanism by which smoking causes cataracts to develops is not fully understood the destruction of antioxidants nutrients by cigarette smoke is one potential hypothesis as antioxidants may help maintain lens transparency.(9)

Diabetic Retinopathy (DR):

Diabetic Retinopathy is a common eye complication of diabetes, occurring when high blood sugar levels over time damage the blood vessels that supply the retina, leading to potential vision loss and blindness if left untreated.(10) Smoking is a significant risk factor for developing DR in type 1 and type 2 diabetes. (11,12) The mechanism in which smoking can lead to DR are unclear. Smoking can also lead tissue hypoxia in retinal vessels which might contribute to the develop of the Diabetic retinopathy.(13)

Thyroid eye disease (TED):

TED is an autoimmune disease in which the tissues around the eye, including the eyelids, eye socket, muscles, and lacrimal gland, become inflamed and swollen, often associated with Graves’ disease or other thyroid conditions.(14) There is strong evidence of dose-dependent correlation between smoking and the development of TED with the risk increasing significantly with the number of cigarettes smoked per day.(15) Other theories for biological mechanism linking smoking to TED have also been proposed: smoking may have a direct irritant action on the eye, causing inflammatory changes, smoking may be a cause of stimulation of the autoimmune process in smokers and smoking may be influence the secretion of cytokine in the eye.(16)

Central Serous Chorioretinopathy (CSR):

CSR is characterized by serous retinal detachment accompanied by the dysfunction of the RPE.(17) It was associated with an increased SubFoveal Choroidal Thickness (SFCT) in CSR patients. Smoking may be an important factor in CSR which is influenced by the choroidal thickness.(17)

Quit smoking or never start:

Smoking not only harms your overall health, but it also accelerates the aging process of your eyes. From premature wrinkles and age spots to cataract and age-related macular degeneration, the risk associated with smoking and eye health are undeniable. Quitting smoking can significantly reduce the risk of developing these conditions and slow down the aging process of your eyes. By kicking the habit, you will not only be protecting your vision but also investing in a healthier, brighter future for yourself. If you’re a smoker, it’s never too late to quit and start safeguarding your eye health today!

Remember, quitting smoking is a journey, and it’s okay to take it one day at a time. Stay committed, and with the right strategies and support, you can overcome the addiction and live a healthier, smoke-free life!

 

References:

  1.  Thornton, J., Edwards, R., Mitchell, P., Harrison, R. A., Buchan, I., & Kelly, S. P. (2005). Smoking and age-related macular degeneration: a review of association. Eye (London, England), 19(9), 935–944. https://doi.org/10.1038/sj.eye.6701978
  2.  Kierstan Boyd, J. Kevin Mckiney, Odalys Mendoza (2024). How do smoking and vaping damage the eyes? American Academy of Ophthalmology. Last accessed on 24th July   https://www.aao.org/eye-health/tips-prevention/smokers
  3. [3] How does smoking affect your vision? ICR. Last accessed on 24th July
  4. https://icrcat.com/en/smoking-and-eye-disorders/
  5. [4] American Council on Science and Health cigarettes what the warning label doesn’t tell you– Information tobacco companies don’t want teens to know about the dangers of smoking. New York: American Council on Science and Health; 2003 p. 98-130.
  6. [5] Khan JC, Thurlby DA, Shahid H, et al Smoking and age-related macular degeneration: the number of pack years of cigarette smoking is a major determinant of risk for both geographic atrophy and choroidal neovascularisation British Journal of Ophthalmology 2006;90:75-80. https://doi.org/10.1136/bjo.2005.073643
  7. [6] Armstrong RA, Mousavi M. Overview of risk factors for age-related macular degeneration (AMD). Journal of stem cells. 2015 Jul 1;10(3):171.
  8. [7] Seddon J. M. (2013). Genetic and environmental underpinnings to age-related ocular diseases. Investigative ophthalmology & visual science, 54(14), ORSF28–ORSF30. https://doi.org/10.1167/iovs.13-13234
  9. [8] Robman, L., & Taylor, H. (2005). External factors in the development of cataract. Eye (London, England), 19(10), 1074–1082. https://doi.org/10.1038/sj.eye.6701964
  10. [9] Sulochana KN, Punitham R, Ramakrishnan S. Effect of cigarette smoking on cataract: Antioxidant enzymes and constituent minerals in the lens
    and blood of humans. Indian journal of pharmacology. 2002 Nov 1;34(6):428-31.
  11. [10] NHS. Overview, Diabetic retinopathy. NHS.2016. Last accessed on 25th July  9:15 PM https://www.nhs.uk/conditions/diabetic-retinopathy/
  12. [11]Hammes, H. P., Kerner, W., Hofer, S., Kordonouri, O., Raile, K., Holl, R. W., & DPV-Wiss Study Group (2011). Diabetic retinopathy in type 1 diabetes-a contemporary analysis of 8,784 patients. Diabetologia, 54(8), 1977–1984. https://doi.org/10.1007/s00125-011-2198-1
  13. [12] Zhong, Z. L., Han, M., & Chen, S. (2011). Risk factors associated with retinal neovascularization of diabetic retinopathy in type 2 diabetes mellitus. International journal of ophthalmology, 4(2), 182–185. https://doi.org/10.3980/j.issn.2222-3959.2011.02.15
  14. [13] Kifley, A., Liew, G., Wang, J. J., Kaushik, S., Smith, W., Wong, T. Y., & Mitchell, P. (2007). Long-term effects of smoking on retinal microvascular caliber. American journal of epidemiology, 166(11), 1288–1297. https://doi.org/10.1093/aje/kwm255
  15. [14] British Thyroid Foundation. Thyroid Eye Disease. 2015. Last accessed on 25th July 10:00 PM   https://www.btf-thyroid.org/listing/category/thyroid-eye-disease-ted
  16. [15]Wiersinga W. M. (2013). Smoking and thyroid. Clinical endocrinology, 79(2), 145–151. https://doi.org/10.1111/cen.12222
  17. [16] Thornton, J., Kelly, S. P., Harrison, R. A., & Edwards, R. (2007). Cigarette smoking and thyroid eye disease: a systematic review. Eye (London, England), 21(9), 1135–1145. https://doi.org/10.1038/sj.eye.6702603
  18. [17] Okawa, K., Inoue, T., Asaoka, R., Azuma, K., Obata, R., Arasaki, R., Ikeda, S., Ito, A., Maruyama-Inoue, M., Yanagi, Y., &Kadonosono, K. (2021). Correlation between choroidal structure and smoking in eyes with central serous chorioretinopathy. PloS one, 16(3), e0249073. https://doi.org/10.1371/journal.pone.0249073

 

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