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Dr.Kayla Bechthold Blog: How Does Smoking Affect My Eyes?

In England this month it is officially “Stoptober”. It is a country-wide effort to help its residents quit smoking. It is based on studies that have shown that if you can quit smoking for 28 days you are five times more likely to be able to never smoke again.

Most people are familiar with what smoking does to the heart, lungs, and vascular systems. Many of my patients are surprised, however, when we discuss how smoking damages the eyes.


Cataracts are like gray hair- everyone gets them eventually. Not all cataracts affect vision enough to be removed. But, if you want to have cataract surgery much earlier than the rest of your friends-keep smoking. Smoking doubles the chances of needing cataract surgery.

Age Related Macular Degeneration

AMD results from damaged retinal tissue in the center of the retina-the macula. The macula is responsible for our sharpest vison- it allows us to read and recognize faces, see 20/20 in the distance for driving. Without a functioning macula life becomes much more difficult.

Studies show smokers have a three times higher risk of developing AMD compared with non-smokes. Female smokers over age 80 are 5.5 times more likely to develop AMD than non-smokers of the same age.

AMD doesn’t have a quick surgical option (like cataracts) to remedy the situation. Besides taking vitamins to help keep remaining tissue healthy, dry AMD has no treatments to date. Wet AMD (when blood vessels form under the damaged tissue) treatments include shots in the eye. Most people don’t choose to volunteer for shots in their eye! But if blindness is the other option, the shots it is.

Quitting smoking at any age can greatly decrease your risk of AMD.


Glaucoma is an eye disease without any symptoms. Sight is lost in the periphery first, so often times it goes unnoticed until it’s too late. There is no pain with glaucoma. Glaucoma is caused when the pressure inside the eye is too high for the retinal nerve tissue to withstand, then the tissue dies. The pressure rise most times is very slow and doesn’t cause any discomfort. Smoking does not cause the eye pressure to increase (as far as we know), but, it does make the tissue inside the eye and the optic nerve starved for oxygen. Because the blood flow in people who smoke is compromised, the blood flow to the retinal tissue and nerve tissue is compromised too. Glaucoma moves more quickly and causes more damage in the eyes of smokers.

Dry Eye

I think most people who have spent any time in a room with people actively smoking have felt the dry eye that smoke causes. Dry Eye disease is more than just a nuisance when your eyes feel dry or scratchy. It can become very severe, causing scarring and extreme discomfort. The front surface of the eye, the cornea, is one of the most densely innervated tissues in the body. With dry eye the nerves in the cornea can become exposed causing non-stop pain. If you know anyone with dry eye syndrome, of if it’s you, the eye drops and eyelid hygiene can be a life altering routine. Smokers are twice as likely to have dry eyes.

Diabetic Retinopathy

Diabetic retinopathy damages the blood vessels of the retina and can result in vision loss. Diabetes causes the blood vessels to become leaky, and the blood that is needed to keep tissue healthy leaks out before getting to the area that needs it. The tissue starved of blood flow slowly dies, and if it is in the eye, vision is lost. Smoking may double the risk of developing diabetes. Smoking also contributes to worse diabetic retinopathy.

Thyroid Eye Disease

Grave’s Disease is a condition where the thyroid gland no longer works as it should. It causes multiple issues all over the body, and the eye is no exception. Thyroid eye disease causes swelling of the eye muscles, leading to double vision and sometimes optic nerve damage, even blindness. Dry eye is also much worse in people with Grave’s disease. Smokers are eight times more likely to suffer from thyroid eye disease then non-smokers.

Things sound pretty grim for smokers- but they don’t have to! The Stoptober message is simple: quit smoking for 28 days and the chance of long term smoking cessation is improved by five times! Ask for help. In Minnesota, the Quit Plan is free for everyone: .

If you have any questions or need a great eye exam, call us today!

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