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How Does Smoking Affect Eye Health?

How Does Smoking Affect Your Eyes?

Published on August 22nd, 2024

Smoking has been proven to negatively affect the eyes, increasing a person’s risk of developing certain eye problems. To protect overall health including eye health, it is strongly advised to quit smoking. Smoking can increase a person’s risk of eye diseases that cause blindness. The effects of smoking on the eyes include an increased risk of cataracts, age-related macular degeneration (AMD), dry eye syndrome, uveitis, diabetic retinopathy, optic nerve damage and Graves’ Disease. These conditions and their definitions are listed below.

  • Increased risk of cataracts: Smoking increases a person’s risk of developing cataracts by two to three times compared to non-smokers.
  • Age-related macular degeneration (AMD): Smoking is a major contributor to the early development of age-related macular degeneration.
  • Dry eye syndrome: Dry eye syndrome is an eye condition that can be aggravated or caused by smoking, leading to red, irritated and gritty eyes.
  • Uveitis: Smoking may cause uveitis which is an eye condition that affects the uvea leading to inflammation of the eye.
  • Diabetic retinopathy: Smoking can increase a person’s risk of developing diabetic retinopathy, which is an eye complication from diabetes.
  • Optic nerve damage: Smoking has been known to cause optic nerve issues and damage which may lead to glaucoma.
  • Graves' disease: Smoking cigarettes can raise a person’s risk of developing Grave’s disease as it affects the immune system.

1. Increased Risk of Cataracts

Smokers are two to three times more likely to develop cataracts than non-smokers, according to the Centers for Disease Control and Prevention. Smoking can increase a person's risk of cataracts as it can damage the proteins in the eye. A cataract is a clumping of protein in the eye’s lens which causes the lens to become cloudy instead of clear. A person may not experience symptoms when they first develop cataracts but as the condition progresses, multiple symptoms that may occur such as blurred or cloudy vision, sensitivity to bright lights and double vision. According to the World Health Organisation, the only way to restore vision once a cataract develops is to surgically remove and replace the cloudy lens.

2. Age-Related Macular Degeneration (AMD)

Smoking is a major contributor to the early development of age-related macular degeneration with this eye condition being the most common cause of blindness in the western world, according to BetterHealth Victoria. Age-related macular degeneration is an eye disease that affects central vision, caused by damage to the cells in the macular. AMD may lead to blurred central vision, dark spots in central vision and difficulty recognising faces. According to the Macular Society, smoking can lead to the development of AMD as it can deplete the levels of lutein in the macula as well as reduce the effectiveness of antioxidants. Smoking can also reduce the amount of oxygen that reaches the choroid, a layer of blood vessels found between the sclera and the retina.

An eyeball affected by age-related macular degeneration.
An eyeball affected by age-related macular degeneration.

3. Dry Eye Syndrome

Dry eye syndrome is an eye condition that can be aggravated or caused by smoking. According to North Florida Cataract Specialists and Vision Care, tobacco smoke may contribute to dry eye syndrome as the smoke breaks down the lipid layer of the tear film. Tobacco is a known eye irritant and can worsen dry eye symptoms. The symptoms of dry eyes may include a sensation of grittiness, stinging and burning, itchiness, redness and blurred vision. Quitting smoking can potentially improve overall eye health and eyesight as tobacco has been proven to cause damage to various parts of the eye.

4. Uveitis

Smoking may cause uveitis, an eye condition that affects the uvea, according to the American Academy of Ophthalmology. Uveitis refers to the inflammation of the eye and can present symptoms such as redness, eye pain, severe sensitivity to light, floaters and blurry vision. The main causes of uveitis may be from autoimmune diseases and infections. Uveitis harms the region of the eye known as the uvea as well as other parts of the eye and can affect one or both eyes.

5. Diabetic Retinopathy

One of the ways smoking can affect a person’s eye is it can increase their risk of developing diabetic retinopathy, which is an eye complication from diabetes. According to Action on Smoking and Health, smoking is a significant risk factor in developing diabetic retinopathy in type 1 and 2 diabetes. While it is unclear the exact ways smoking leads to diabetic retinopathy, one connection can be seen as smoking may cause tissue hypoxia in retinal vessels which can contribute to its development. Diabetic retinopathy occurs due to damage to the small blood vessels in the retina located at the back of the eye. According to HealthDirect Australia, the symptoms a person may experience with diabetic retinopathy are blurred vision, pain in the eyes, eye floaters, sensitivity to glare and trouble seeing at night.

6. Optic Nerve Damage

Smoking has been known to cause optic nerve issues and damage. According to the American Academy of Ophthalmology, smokers risk having optic nerve problems which may lead to glaucoma as it is a disease that affects the optic nerve. The optic nerve is located in the back of the eye and carries visual information to the brain. Damage to the optic nerve may lead to blindness. Eye conditions related to the optic nerve include glaucoma, papilledema, optic neuritis and optic atrophy.

7. Graves' Disease

Smoking cigarettes can raise a person’s risk of developing Grave’s disease as it affects the immune system. According to the Mayo Clinic, smokers who have Grave’s disease are also at a higher risk of developing thyroid eye disease. Grave’s disease is an autoimmune disorder that results in an overactive thyroid, known as hyperthyroidism. Grave’s disease can affect many parts of the body including the eyes causing symptoms such as puffy eyelids, dry and gritty eyes and eyelids that pull back more than usual, according to the National Eye Institute. A study published in the National Library of Medicine titled, Smoking and risk of Graves' disease, found that smoking appears to be one of many factors causing Grave’s disease in those who are genetically predisposed.

What do Eyes Affected by Smoking Look Like?

Eyes affected by smoking look different depending on how it is affected. An eye affected by cataracts, which is a common cause of smoking, will appear with a cloudy, white area in the middle of the eye known as the lens, according to the American Academy of Ophthalmology. Smoking can also cause red or bloodshot eyes due to its stimulant properties.

A man with an eye affected by smoking.
A man with an eye affected by smoking.

What Happens When Smoke Hits Your Eyes?

Cigarette smoke can cause the eyes to become red due to the chemicals found in cigarettes and the smoke. According to Dean McGee Eye Institute, nicotine which is found in tobacco acts as a stimulant, leading to increased heart rate and narrowing of blood vessels. Your body overcompensates for this, pumping more blood which can cause red eyes. Cigarette smoke is also an eye irritant and can lead to a breakdown in tear film when it hits the eye, leading the eye to dry out and leaving it red and uncomfortable.

Does Smoking Cause Glaucoma?

According to the BrightFocus Foundation, there is a strong link between smoking and glaucoma. Research shows that glaucoma is more than twice as likely to get worse in people who are big smokers. Glaucoma refers to a group of eye conditions or diseases in which damage to the optic nerve causes vision loss. Another study discussed by the BrightFocus Foundation found that the more a person smokes, the less blood is supplied to the optic nerve for those with glaucoma.

Does Smoking Dehydrate Your Eyes?

Yes, smoking can dehydrate your eyes as according to the website, My Dry Eye Disease, smoking promotes tear evaporation, leading to irritation and discomfort. Tobacco is a known eye irritant that can contribute to dry eye syndrome, according to the North Florida Cataract Specialists and Vision Care. Tobacco is the main component of cigarettes with nicotine being the main chemical in tobacco.

Does Eyesight Improve After Quitting Smoking?

While quitting smoking does not necessarily improve your eyesight it does lower your risk of developing cataracts and age-related macular degeneration, both of which affect a person’s eyesight. According to the Centers for Disease Control and Prevention, quitting smoking can help save your eyesight.