We are all aware that smoking causes harm to every organ of our body – including our eyes. It may come as a surprise to some as we tend to associate lung problems and oral cancers as the more common manifestations of smoking. But our vision can also be affected by smoking.

Smokers are at a higher risk of many visual problems. However, even passive smoking and exposure to environmental smoke can also increase susceptibility amongst non smokers. Exposure to passive smoking and environmental smoke can also be very toxic. Cigarette smoking contains many active compounds specially carbon monoxide which is very harmful.

This article will focus on the different eye problems associated with smoking, with an emphasis on cataracts.

How does vision get affected?

The fibers of the eye receive fresh, oxygenated blood which maintains their elasticity. Smoking can interrupt blood flow to these structures, which cause damage to the tissues, ultimately resulting in vision loss. Sometimes, exposure to toxic smoke can also cause accumulation of certain metals on the eye lens. Smoking also alters the lenses through oxidation. The effect of the damage depends on which region of the eye is affected – the retina, macula, uvea or optic nerve.

Visual problems associated with Smoking

  • Macular Degeneration 

The macula is an oval shaped structure near the center of the retina. When blood flow to this region is less or the tissues degenerate, vision can get affected.

The macula receives fresh oxygenated blood and this helps the finer details of vision such as clarity and sharpness of central vision. Hence, when degeneration occurs, basic everyday tasks such as reading, driving, sewing or writing can be affected. Vision becomes blurry, blind spots occur in central vision, images may be distorted and ultimately vision can be completely lost. Macular degeneration is more common amongst those above 65 years of age but for smokers, early degeneration is seen. The rate of degeneration for each eye can also be different.

  • Uveitis

The uvea is the middle layer of the eye and consists of the iris, the choroid and the ciliary body. Smoking can lead to inflammation of the uvea, thereby affecting vision that needs to adapt to long ranges and different intensities of light. If the iris or retina also get damaged, it can lead to further complications such as retinal detachment.

  • Diabetes Retinopathy 

This is seen amongst smokers who already have Type 1 or Type 2 diabetes. The blood vessels of the retina can get damaged in smokers, thereby resulting in visual impairment.

Smoking is also a lifestyle based risk factor in the development of diabetes. Once contracted, if the individual continues to smoke, the retinal damage gets accelerated.

  • Dry eyes

Frequent smokers often suffer from dry eyes which are characterized by itching, redness, soreness or watering of the eyes. This happens because the tear glands do not produce enough tears to lubricate the eyes. Tobacco is associated with dry eyes and this condition worsens if the individual wears contact lenses. Dry eyes often result in itching and sometimes, if the person scratches their eye roughly, it could lead to ulcerations in the cornea. Exposure to smoke in the environment also causes this.

  • Fetal eye disorders 

Fetal birth defects can occur when women who are chronic smokers continue smoking during their pregnancy. The optic nerve being underdeveloped, lazy eye and crossed eye are examples of the structural defects that could occur.

  • Cataracts

 Cataracts occur when the natural lens of the eye becomes cloudy. This is the leading cause of blindness worldwide, along with macular degeneration. Cataracts are accompanied by blurry vision, fading of colors and increased sensitivity of the eyes.

There is increased risk of developing cataracts among smokers as compared to non smokers. The risk is almost double with regular smokers and triple with heavy smokers. Therefore, the risk of developing cataracts also increases with an increase in the frequency of smoking. Below more information about cataract in India.

Cataract Eye Surgery in India

Apart from Macular Degeneration, Cataracts are the leading cause of blindness globally. In India alone, cataracts account for nearly half the cases of organic blindness. The individual experiences symptoms such as blurry vision, sensitivity to glare from the sun, seeing halos around bright light and affected color vision.

Cataract surgery involves removal of the cloudy lens and has to be done by a well trained and experienced surgeon. Post anesthesia, an incision is made in the front of the eye. An instrument is inserted to dissolve the cataract and gently pull it out through suction. A new lens is then implanted and the incision is closed.

Cataract surgery is widely popular in India. It is a very safe procedure where side effects are rare. The surgery is largely becoming more affordable and available all over India, especially in the cities. Organizations like Help Age India work at making this procedure more accessible to the elderly who may need help through funding or bringing it closer to their towns. As hospitals in India have developed in terms of quality and expertise, cataract surgery in India attracts a lot of international clients, thereby promoting medical tourism. The cost of the surgery varies according to the hospital and city chosen to have the surgery in and also according to the type of surgery (laser, keyhole, microsurgery) and the type of lens used for implantation. Effective procedures can start around 20,000 INR and may go up to 60,000 INR.