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How Smoking Affects Vision: Risks, Diseases & Statistics

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Smoking damages most systems in your body, including your eyes. Cigarettes are known to be especially harmful, but other methods of ingesting nicotine like vape pens and smoking marijuana can also damage your eyesight.

Diseases associated with smoking cigarettes include chronic dry eyes, cataracts, age-related macular degeneration, uveitis, and optic nerve damage. Although cigarettes are known to be the most harmful, vaping or using e-cigarettes with nicotine oils and smoking marijuana also appear to damage your vision.

The best way to ensure your vision stays as healthy as possible is to quit smoking, regularly visit your eye doctor, and inform them of your former smoking habits. If you’re a former smoker, you can repair some of the damage to your eyes by avoiding smoking in the future and staying on top of your overall health.

Smoking & Vision Damage Are Closely Linked

mans forehead eyes pinched shut

Smoking is one of the most harmful habits for your body, damaging internal organs like your lungs, heart, and brain.

Cigarette smoking is tied to several issues, including damage to your teeth, skin, and eyes. Since chemicals in nicotine, especially as cigarettes, damage cells in the body, the delicate cells that make up various parts of your eye can be severely affected.

The campaign against smoking cigarettes has led to a drop in the number of smokers in the United States, but the use of vape pens and e-cigarettes is rising in popularity. Recent medical studies suggest that any consumption of tobacco can harm your eyesight.

Marijuana legalization has also led to a rise in marijuana smoking around the country. Smoking marijuana can also contribute to some vision problems.

The best way to avoid harm to your vision or reduce your risks of vision issues is to quit smoking. Long-term studies have suggested that quitting cigarettes allows cells in your eyes to slowly repair themselves, so risks of certain eye diseases go down over time. However, these risks do not completely go away. The best way to avoid this type of harm is to never start smoking.

Eye Diseases Associated With Smoking Cigarettes

Smoking, especially cigarettes, has been tied to several eye diseases. These can increase your risk of poor vision, amplified vision problems, and vision loss. You could even go blind if you do not quit smoking and receive appropriate treatment for your eyes.

Medical researchers have linked chemicals in cigarette smoke in particular, and nicotine in general, to various eye issues. They cause blood vessels to constrict. This limits blood flow all over the body, which can be very damaging to the delicate tissues in the eye.

Here are the most common eye diseases associated with smoking cigarettes:

Dry eye

Many people experience eye strain or temporary irritation that causes their eyes to make fewer tears. If you have chronic dry eye, however, your eyes could appear red or irritated. They will feel uncomfortable, scratchy, stinging, or painful.

Chronic dry eye is a problem caused by your tear ducts being unable to produce enough natural tears. Your eyes may not make enough of the right kind of tears too, which are called tear film. This film is made from three layers, including:

  • A watery layer.
  • An oily layer.
  • A mucus layer.


This combination helps tears stay on the surface of your eye for long enough. When you blink, these natural tears are released and spread around your eye, unless your tear ducts do not work properly, which is the case with dry eye.

If you have dry eye and you do not work with your optometrist or ophthalmologist to manage the condition, you are at higher risk of secondary problems like infections or inflammation. Over time, these ongoing issues could damage your eye and cause vision loss.

Smoking causes smoke particles to be near your eye, which can irritate the surface. Chemicals in smoke could damage your tear ducts from the inside, leading to tear-making problems.

Cataracts

This vision problem starts with damaged proteins in the lens of your eye, which sits right behind your pupil and helps focus light onto your retina. Typically, this organ is clear. When damaged proteins begin to clump together, however, you may develop white spots, clumps, yellowed or discolored areas, or dark streaks that obscure parts of your vision. These are cataracts.

Getting regular eye exams helps your optometrist diagnose this condition early and monitor its progress. Your doctor may recommend surgery to remove the damaged lens when the cataract obscures your vision too much. It usually takes several years to progress to this point.

Cataracts are very common. Many people over 60 years old develop them, and more than half the adult population over 80 years old has undergone cataract surgery. This surgery removes the damaged, natural lens and replaces it with an artificial lens. Your eye doctor will not recommend surgery until your vision has been significantly impaired.

Although there are several factors that put you at risk for getting cataracts, any tobacco consumption increases your risk of developing this problem. Cigarette smoking doubles your risk of developing cataracts.

Smoking is especially harmful, but chewing tobacco has also been linked to an increased risk of cataracts. Quitting smoking allows your eyes to heal, but it can take more than 20 years to reduce your risk of cataract development.

Age-related macular degeneration (AMD)

The central part of your retina is called the macula, and it is predominantly responsible for your central, as opposed to peripheral, vision. Like cataracts, AMD is a very common eye disorder in people who are older — typically, those who are at least 50 years old.

Most people develop dry AMD, when clumps of a protein called drusen accumulate on the retina, so vision diminishes slowly. Wet AMD is a more serious condition, occurring when blood vessels grow in and around the retina to compensate for the lack of blood flow caused by collected drusen.

While AMD is treatable, it is a chronic condition. Smoking doubles your risk of developing AMD. Unlike with cataracts, your risk for AMD remains high after you quit smoking.

Discuss your former smoking habits with your eye doctor. This can help them track any signs of AMD during regular, dilated pupil eye exams.

Diabetic retinopathy

If you have diabetes and you smoke, you greatly increase your risk of diabetic retinopathy. This is a condition that causes damage to the retina, as blood vessels throughout the body are damaged from unregulated blood sugar. Type 1, type 2, and gestational diabetes all put you at higher risk of diabetic retinopathy.

Smoking exacerbates blood pressure issues and organ damage, increasing your risks of developing diabetic retinopathy. Smoking also causes the condition to move faster, so you will lose your sight more quickly.

Uveitis

This is a disease of the middle part of the eye, causing the white part (sclera) to look red, inflamed, and swollen. Uveitis can affect the front, middle, and back parts of the eye differently, but untreated uveitis can cause damage to other parts of the eye and lead to vision loss. Smoking increases the risk of blood vessel issues that can trigger uveitis.

Optic nerve damage

The optic nerve takes signals from the retina and sends them to the brain. Damage to this cluster of nerves can cause permanent vision loss that is difficult to treat.

Smoking damages several types of cells in the body due to toxic chemicals, and this includes nerves. Smoking increases fluid pressure in the eye, which can cause a type of glaucoma that will also put pressure on the retina and the optic nerve, leading to damage.

People who smoke are 16 times more likely than nonsmokers to suddenly lose their vision due to optic nerve damage, especially if the damage is caused by a blood clot or blockage of blood flow.

Other Forms of Smoking Are Also Harmful to Your Eye Health

vaping man

The Surgeon General of the United States published a landmark study in 1964 on the dangers of cigarette smoking, so the American public has known for decades that cigarettes are extremely detrimental. Other forms of “smoking” are becoming popular, and these put your vision at risk too.

Unfortunately, medical researchers do not know the full extent of the risks of vaping nicotine or smoking marijuana on eyesight, as they do with cigarettes. Still, small-scale medical studies suggest that both are dangerous to your vision and other aspects of long-term health.

Vaping nicotine

Vaping devices and e-cigarettes have come under scrutiny recently as more than 1,000 people reported serious lung disease and 18 people died after vaping. These issues were associated with oils in vaping products, which caused acute lung problems. Some studies suggest that vaping nicotine or using e-cigarettes, even as a method of quitting cigarette smoking, can be harmful to your vision.

A study published in Optometry and Vision Science found that vaping nicotine products can irritate the ocular surface, increasing chronic dry eye risk along with inflammation and the risk of eye infections. The study followed 21 people who used e-cigarettes, along with a control group of 21 nonsmokers. Both groups’ eyes were evaluated, especially the quality of their tears. Researchers found that exposure to harsh chemicals coming from vaping pens irritated the eyes and made chronic dry eye worse.

Smoking marijuana

As of 2019, 11 states and the District of Columbia have legalized recreational marijuana use, and most states in the U.S. have allowed some level of medical marijuana use. As popularity and acceptability of this drug grow, more people are abusing it, while fewer people smoke cigarettes.

Despite increasing acceptance, marijuana is still addictive and dangerous, especially if it is smoked. Cannabis-based substances can affect your vision and lead to vision loss, although this process is not as well understood as with nicotine products.

Some medical cannabis advocates have pushed for the drug to be used as a glaucoma treatment, and small studies have shown that marijuana does decrease fluid pressure in the eye. However, this decrease lasts as long as the drug is most potent in your body, typically a few hours. After that point, fluid pressure returns to its original level. This is not long enough to provide a significant impact on ocular health, and it could cause more retinal damage with too many fluctuations of fluid pressure over time.

In contrast, modern prescription glaucoma treatments keep ocular pressure low for several hours. They can safely be used consistently without causing dangerous intoxication or damaging other organ systems.

Cannabis can also decrease the effectiveness of signals between the retina and the optic nerve. A small study of 28 marijuana users and 24 nonusers found that there was a delay in vision processing in people who used cannabis. It is unclear if this effect is permanent or caused by being high, but it can be risky.

There are also visual problems, like blurry vision, associated with using marijuana. This can impact your short-term ability to see.

Avoid Smoking to Keep Your Eyes Healthy

Whether you use cigarettes, vape pens, or marijuana, quitting smoking allows your eyes time to heal and regenerate some cells. You can lower your risk of all eye diseases with years of remaining abstinent from smoking. You will not completely remove your risk, as harm from smoking stays with you for decades after you quit. But the lessened risks are greatly worth quitting.

If you are a current or former smoker, you can work with your physician on ways to quit and stay abstinent. Work with your optometrist or ophthalmologist to manage your risks of certain eye diseases.

You will benefit from getting an annual eye exam regardless of age, so your eye doctor can monitor any potential of AMD, cataracts, glaucoma, or vision loss. Chronic eye disease can reduce your vision, but many of these conditions are very treatable. You can maintain good vision for many years if you are diagnosed early, so make sure to stay on top of your eye health.

References

  1. Overview of Smoking and Eyesight. (March 2018). Centers for Disease Control and Prevention (CDC).
  2. Smoke Signals: Links Between Smoking and Eye Disease. (June 2014). American Optometric Association (AOA).
  3. Smoking and Eye Disease. (April 2019). American Academy of Ophthalmology (AAO).
  4. What Is Dry Eye? (August 2019). American Academy of Ophthalmology (AAO).
  5. What Are Cataracts? (October 2019). American Academy of Ophthalmology (AAO).
  6. Smoking Cessation and the Risk of Cataract. (March 2014). Journal of the American Medical Association (JAMA), Ophthalmology.
  7. What Is Macular Degeneration? (May 2019). American Academy of Ophthalmology (AAO).
  8. What Is Diabetic Retinopathy? (October 2019). American Academy of Ophthalmology (AAO).
  9. What Is Uveitis? (August 2019). American Academy of Ophthalmology (AAO).
  10. Smoking “Damages Eyes as Well as Lungs.” (July 2019). BBC News.
  11. How Vaping Affects the Ocular Surface. (October 2017). Optometry Times.
  12. Vaping Linked to Worse Ocular Surface Disease. (September 2019). Review of Optometry.
  13. State Marijuana Laws in 2019 Map. Governing: The Future of States and Localities.
  14. Studies Look at Effects of Marijuana on Vision. (February 2017). American Academy of Ophthalmology (AAO).

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