Where There’s Smoke, There’s Fire

Written by Dr. David Evans   Last modified on August 6, 2018

I like the simple pleasures in life. An early morning run in the summer sun. The smell of charcoal as it warms up a barbeque. Sunday brunch with my family is always a great event. And I’m quite partial to the occasional cigar. I stress “occasional” because I don’t consider myself a smoker. I’m too aware of the health perils tied to smoking to make it a regular habit.

Smoking is the leading cause of preventable disease and death in the U.S. You’re no doubt aware of the links between smoking and cancer, smoking and heart disease, and smoking and emphysema. But did you know that smoking can also seriously damage your visual health?

The Eye Disease Connection

Smoking increases your risk for developing a number of eye conditions and diseases that can lead to blindness. Although those most at risk are the smokers themselves, second-hand smoke is also damaging.

Dry Eye

One of the more benign conditions linked with smoking is dry eye, a condition marked by insufficient tear flow. The lack of lubrication can lead to stinging, burning or itching, sensitivity to light, blurred vision, eye fatigue, redness and more.

Any type of smoke is an irritant that can impact eye health and vision. Because smokers are constantly immersing themselves in a plume of smoke, they are twice as likely to develop dry eye than nonsmokers. This risk is accentuated for contact lens wearers, because the poisonous particles in smoke can get caught behind the contact lens, trapping them against the eye.

Learn more about dry eye


Cataracts is the leading cause of blindness worldwide. It is marked by clouding of the lens. Although typically age-related, affecting people over the age of 40, cataracts can result from other, less common causes. (In rare cases, cataracts can be congenital from birth.)

Like dry eye, smokers are twice as likely to develop cataracts than nonsmokers.

Learn more about cataracts


Inflammation affecting the middle layer of the eye wall (uvea) results in a condition known as uveitis. The acute nature of the condition means that its symptoms typically develop suddenly and without warning. Uveitis can affect one or both of the eyes, and is most common among people between the ages of 20 and 50. Early diagnosis of uveitis is key to preventing serious damage to the eye(s). In addition to being a primary risk factor for developing cataracts, glaucoma and retinal detachment, uveitis itself can lead to permanent blindness.

Studies have found that smokers are as much as 2.2 times more likely to develop uveitis than nonsmokers.

Macular Degeneration (AMD)

Macular degeneration is an age-related condition marked by a deterioration of the macula, the small central part of the retina responsible for seeing fine details and colors. Also called AMD, macular degeneration is the leading cause of blindness for people aged 65 and older. Sufferers experience vision distortion, blind spots, blurred distance and/or reading vision, impaired color vision, reduced contrast sensitivity and more.

If you live long enough, you will eventually develop AMD. It’s not a question of “if,” it’s a matter of “when.” However, smokers are three times more likely to develop AMD than nonsmokers. Female smokers over the age of 80 see their risk jump by a whopping 5.5 times compared to nonsmokers.

Learn more about macular degeneration

Diabetic Retinopathy

Diabetics are more susceptible to a number of health issues, including diabetic retinopathy, an eye condition marked by damage to the blood vessels of the retina. The leading cause of vision loss among people with diabetes, diabetic retinopathy affects more than 30 million Americans and can cause blurred vision, reduced contrast sensitivity, eye floaters, poor night and color vision, and more.

Smoking is a risk factor for developing diabetes. In fact, smokers are twice as likely to develop diabetes than nonsmokers. Diabetic smokers are also more likely to develop diabetic retinopathy than diabetic nonsmokers.

Learn more about diabetic retinopathy

The Good News

If you are a smoker concerned about eye health, there is some good news. According to the American Academy of Ophthalmology, people who are able to quit smoking essentially void their previously heightened risk factors for some of these conditions. This good news is all the more reason to make the healthful decision to a smoke-free lifestyle. Speak with your primary care physician or eye doctor for more information about the perils of smoking and get help quitting today.

For continued reading, check out our Tips for Maintaining Eye Health slideshow.