Smoking & Your Vision

Do You Still Smoke?

Smoking & Vision

The connection between smoking and vision health is well established. There is a significant correlation between damage to vision beginning before your child is born and continuing to illnesses that manifest late in life. The very best thing you can do for yourself and your family is to do everything you can to stop smoking. Now!

When you smoke, whether cigarettes or other 'smokables,' your body produces hydrogen cyanide which is a toxin that affects the retina, the lens of the eye, the optic nerve, and causes inflammation within ocular tissues. It damages the formation of optic neural systems in your unborn child and the gene integrity that governs their future vision. Hydrogen cyanide is only one of many toxins produced by tobacco/paper/filter combustion that negatively affects eye health.

Some of the conditions cause by or aggravated by cigarette smoke include:

Smoking causes, aggravates, or increases the risk of all of these conditions, and others. To compound the problem, in a 2016 survey of Americans (average age 46) a third of them were unaware of cataracts or glaucoma, only half were aware of macular degeneration, and a little more than a third were aware of diabetic retinopathy.1 When smokers fall into these large unaware groups the consequences are severe.

Toxins in Cigarettes

The list of harmful toxins posted by the FDA is daunting - more than 100 listed harmful and potential harmful substances, including some you've heard of such as ammonia, acetone, arsenic, benzene, carbon monoxide, formaldehyde, hydrogen cyanide, lead, mercury, and uranium.

Hydrogen cyanide is produced by a chemical reaction when tobacco burns, rendering it unstable. The problem with hydrogen cyanide is that it inhibits the ability of the cells of almost every organ of the body, .

Benzene, another toxin produced by smoking, was found to cause many serious side effects in children exposed in an industrial accident, including vision difficulty.3 Benzene exposure contributes to cell death due to internal membrane hemorrhaging.4

Carbon monoxide is well known for its ability to deprive the body of oxygen resulting in serious health issues. One of the side effects of carbon monoxide poisoning is vision loss.5 Exposure can result in hemorrhaging of the retina and vitreous membranes.6 While these cases are of higher levels of poisoning than in a single cigarette, nonetheless the presence of the toxin has an impact on your vision.

'Super-slim' is a type of cigarette marketed in Canada which supposedly is less toxic. While it does contain less tobacco and has filters that lower the level of toxins inhaled, the level of formaldehyde and phenols is higher, leaving the cigarettes just as toxic as regular cigarettes.7


Smoking research conclusively demonstrates that the habit significantly increases the risk of cataracts. For women who smoke more than a pack a day, the risk is 63% higher than not smoking; for men, it is 205% higher. Smoking also increases the development of cataracts in the front and edges of the eye lens in those aged 21 to 30.8 Large, very long term (40) studies substantiate the fact that smoking sharply increases the risk of developing cataracts.9, 10

Dry Eyes

Researchers have determined that cigarette smoke toxins impact the proper functioning of tear secretion and density of goblet cells (which secrete the mucous that lines the eyelids). The degree of damage increased with the amount of smoking.17

Fetal Optic Nerve Damage

The babies of mothers who smoke while pregnant are 10% more likely to begin life with damaged optic nerves. The babies born to smoking mothers have significantly thinner layers of retinal nerve fiber.18 Exposure to prenatal toxins from smoke also degrades the pigmented layers of the retina19 and also damages the nerve ganglions and the overall thickness of the retina.20


Smokers have a much larger risk of developing glaucoma than non-smokers.9 There has been research to suggest that smoking marijuana reduces intraocular eye pressure - and it does, but only for several hours. In addition, because it reduces blood pressure it may reduce blood supply to the optic nerve and could thereby worsen vision. A recent review of the relationship between glaucoma and cigarette smoking found that the evidence for a causal link is stronger than as evidenced in past research.15 What is clear is that here is a strong connection between smoking and two of the other risk factors for glaucoma: cataracts and diabetes.

Macular Degeneration

Smoking has been found to significantly increase the risk of macular degeneration (AMD). It doubles the risk of developing macular degeneration and increases the risk of having the more serious wet form of the condition rather than the dry form. If AMD is detected early enough, stopping smoking can be somewhat reverse AMD or even stop the progression.11 Smokers with AMD are more likely to have larger macular lesions than non-smokers. Smokers with a genetic condition which in itself increases the risk also experience more serious developments of AMD than non-smokers.12 Other research has found that smokers' macula tissue has higher levels of damage, higher levels of a biomarker associated with inflammation, and high levels of oxidative damage due to free radicals in the retinal pigmented layers.13

Macular Degeneration & Alzheimer's. AMD is known as a retinal disease, but clinical studies have found a link between AMD and Alzheimer's. The types of changes that take place in Alzheimer's patients with AMD may be hastened by smoking cigarettes.11

Optic Nerve Damage

Smokers are 16 times as likely to develop conditions involving damaged optic nerves. For example, Leber's Hereditary Optic Neuropathy is a disease of the optic nerve in which the mitochondria (the energy-producing cells) in the nerve cells of the retina are damaged. The deterioration occurs because certain genes do not express themselves properly. Some patients may have the genetic mutation which causes them to carry the mutated gene but not themselves experience the vision damage - mostly because the effectiveness of their physiology in fighting free radicals. However the toxins in cigarettes trigger the condition in at risk patients.14


Uveitis is caused by inflammation of the tissues of the eyes. Iritis refers to the frontal tissues, cyclitis refers to the ciliary bodies behind the iris, and choroiditis refers to blood vessel carrying tissues behind the ciliary body. People who smoke are more likely to develop uveitis as compared to non-smokers. Toxins in cigarette smoke cause tissue inflammation. The condition is initially an inflammatory disease, which can have infection complications. Smokers were almost twice as likely to develop the infectious complication, and more than twice as likely to develop the inflammatory non-infectious version.16


Repeated research finds that the toxins contained in cigarette smoke (and indeed, in may other sorts of environmental air pollutants) have a significant damaging effect on your vision and eye health and comfort. Such degradation of the parts of the eye needed for good vision is almost entirely more severe related to the amount and duration of smoking habits.

Therefore stopping smoking is one of the most important things for you to do to protect your precious vision.


1. A. W. Scott, et al, Public Attitudes About Eye and Vision Health, JAMA Ophthalmology, August, 2016.
3. M.A. D'Andrea, et al, Illness Symptoms Experienced by Children Exposed to Benzene After a Flaring Incident at the BP Refinery Facility in Texas City, Clinical Pediatrics, May, 2016.
4. B.K. Hong, Bilateral subinternal limiting membrane hemorrhage in benzene toxicity, Retinal Cases and Brief Reports, Fall, 2014
5. M.F. Harif, Cortical venous infarcts and acute limb ischaemia in acute carbon monoxide poisoning: A rare case report, Journal of the Pakastan Medical Association, June, 2016.
6. M. Leving, Vitreous Hemorrhage from Carbon Monoside Retinopathy, Retinal Cases and Brief Reports, Spring, 2016
7. M. Siu, et al, The analysis of mainstream smoke emissions of Canadian 'super slim' cigarettes, Tobacco Control, November, 2013
8. Smoking and Cataracts Research - 1991-1994
9. J. H. Kang, et al, Contribution of the Nurses' Health Study to the Epidemiology of Cataract, Age-Related Macular Degeneration, and Glaucoma, American Journal of Public Health, September, 2016
10. T. Iroku-Malize, S. Kirsch, Eye Conditions in Older Adults: Cataracts, FP Essentials, June, 2016
11. Sha Sha Yu, et al, Links between the Brain and Retina: The Effects of Cigarette Smoking-Induced Age-Related Changes in Alzheimer's Disease and Macular Degeneration, Frontiers in Neurology, July, 2016
12. D. Stanislovaitiene, et al, SCARB1 rs5888 is associated with the risk of age-related macular degeneration susceptibility and an impaired macular area, Ophthalmic Genetics, July, 2016
13. Smoking and Macular Damage
14. L. Giordana, et al, Cigarette toxicity triggers Leber's hereditary optic neuropathy by affecting mtDNA copy number, oxidative phosphorylation and ROS detoxification pathways, Cell Death and Disease, December, 2015.
15. V. Jain, et al, The association between cigarette smoking and primary open-angle glaucoma: a systematic review, International Ophthamology, May, 2016.
16. Brenton G. Yuen, et al, Association between Smoking and Uveitis, Results from the Pacific Ocular Inflammation Study, Ophthamology, June 2015
17. Y. Uchino, et al, Impact of Cigarette Smoking on Tear Function and Correlation between Conjunctival Goblet Cells and Tear MUC5AC Concentration in Office Workers, Scientific Reports, June, 2016.
18. V. Pueyo, et al, Effects of smoking during pregnancy on the optic nerve neurodevelopment, Early Human Development, May, 2011
19. L. Yang, et al, Nicotine alters morphology and function of retinal pigment epithelial cells in mice, Toxicologic Pathology, June, 2010
20. C. Evereklioglu, et al, Effect of gestational nicotine treatment on newborn rat retina: a histopathological and morphometric analysis, Ophthalmic and Physiological Optics, November, 2003.