Cigarette Smoking and Your Eyes
Frequently, I recommend to my patients that they stop smoking. I do not demand this of them because as adults, they have the right to decide how they live their lives. I understand that it is no easy task to stop a habit that for many, has been a source of relaxation and pleasure for decades. However, it is my responsibility to inform them how tobacco use is harming their body, especially their eyes.
A study done years ago on fisherman of the Chesapeake Bay showed that the incidence of cataracts was significantly higher in these individuals who were exposed to sunlight on a daily basis. Unfortunately, the study was obscured by the fact that most of the individuals also smoked heavily. It was uncertain how much of an impact this factor made in the development of cataracts. However, more recent studies have shown a strong link between cigarette smoking and the development of cataracts. It is fortunate that cataract surgery can cure this problem and restore good vision. Unfortunately, many consequences of smoking have no surgical or medical cure.
A large number of smokers will develop emphysema or chronic obstructive pulmonary disease (COPD). COPD is a disease of the lung tissue that results in loss if the microscopic sacks of tissue (alveoli) that are responsible for allowing oxygen and carbon dioxide to be efficiently exchanged from the bloodstream. The result is a reduced oxygen level in the bloodstream with retention of carbon dioxide. Patients suffer from chronic shortness of breath and many require supplemental oxygen from portable tanks, twenty four hours a day.
Within the eye, highly metabolic retinal tissue requires large amounts of oxygen to function normally. Deprive the retina of this requirement and damage will occur. Patients with severe COPD are more susceptible to sight threatening retinal problems. Moreover, if a patient with emphysema also has diabetes, the visual prognosis frequently is poor.
Recent studies have shown that smokers with macular degeneration have a greatly increased risk of retinal swelling and hemorrhages, which frequently result in significant, irreversible damage. Macular degeneration is already the leading cause of blindness in individuals over age sixty five. Although laser treatment can reduce the progression of the retinal damage, many patients will end up legally blind.
I have many patients who want to stop smoking but find it very difficult. I have others who have no desire to stop. It is their decision. They should realize that upon quitting, it takes almost fifteen years before the risk of smoking related problems is reduced to the level of a non-smoker.
