by Sheila West, PhD
“Smoke gets in your eyes” is more than a catchy song, it is a real problem. According to the 50th Anniversary Surgeon General’s Report on Smoking and Health, smoking is a cause of two of the most significant eye diseases in the world. One of these diseases, Cataract, is the primary reason for vision loss in the world, accounting for 51% of the burden of blindness. When the lens of the eye, the clear structure behind the pupil, becomes opaque, then patients have cataract. Research has shown that cataract disproportionally affects women, although the reasons for the disparity are unknown. The risk of cataract increases with the amount smoked, and studies have shown that quitting smoking reduces that risk.
Age-related macular degeneration is the leading cause of vision loss in the United States. It is a significant problem among the elderly, and because more women than men live to advanced years, women have more age-related macular degeneration overall. The macula is the central part of the retina that allows patients to read and see fine details. When the macula deteriorates with this disease, it destroys central vision. The recent Surgeon General’s report has found smoking to cause age-related macular degeneration, particularly the “wet” or exudative form. Research suggests mixed results on the benefit of quitting smoking, with benefit reported in those who quit early in life.
We do not know the effect of E-cigarettes (electronic cigarettes) on eye health, as they have appeared only recently on the market. Nevertheless, the best strategy is never starting to smoke, followed by quitting altogether as soon as possible. As eye care practitioners and researchers, we now add eye health to the growing list of smoking-related concerns, and patients need to understand that smoking can blind as well as kill.
About Sheila West
Sheila West, PhD, is the Vice Chair for Research at the Wilmer Eye Institute at Johns Hopkins Medical Institutions. She received her PhD from the Johns Hopkins School of Public Health, and is also a professor in the Department of Epidemiology. She has investigated the role of smoking in eye health in numerous studies of populations, and has published over 300 scientific articles. Dr West wrote the chapter on Smoking and Eye Disease for the latest version of the Surgeon General’s report. She was the first female President of the Association for Research in Vision and Opthalmology, and serves on numerous Boards and Foundations.