In India, there has been an increasing trend in smoking among teenagers, be men or women. While tobacco consumption is stable or declining in developed countries, it is increasing in the developing world with a rate of approximately 3.4 % per annum due to steady population growth coupled with tobacco industry targeting and ensuring that millions of people become fatally addicted each year.

It is well known that smoking is a risk factor for heart disease and lung cancer; however, smoking can also lead to different eye diseases. Smoking or tobacco causes damage by causing oxidative damage and narrowing of blood vessels.Tobacco in any form – cigarettes, biri, and tobacco chewing – is potentially harmful.Avoiding smoking, or taking steps to quit, lowers the risk of vision impairment and vision loss.

Teenage or young age smoking, per se, does not pose a higher risk by itself. It is just that the cumulative effect of smoking over longer duration adds up (more pack-years) and the effect is more by the time such smokers get older.
Also, smoking does not only harm the smoker, but the effect is also seen in second-hand smokers especially children.

Smokers are at higher risk for:
• Age-Related Macular Degeneration (AMD): Smokers are 3 to 4 times more likely to develop AMD (retinal thinning and weakness) than non-smokers.
• Grave’s Disease (Thyroid ophthalmopathy): is an autoimmune disease of thyroid gland and smoking is a major significantrisk factor. Smoking cessation is one of the first steps of treatment.
• Diabetic Retinopathy: Complications of diabetes made worse by smoking which include diabetic retinopathy and maculopathy.
• Dry Eye Syndrome: Is twice more common among smokers than non-smokers. Smokers who wear contact lenses have four times the increased risk of infection.
• Cataract: Heavy smokers are more likely to develop early cataracts than non-smokers
• Glaucoma: Older smokers have a higher risk of developing increased eye pressure and glaucoma
• Optic nerve problems: Smoking decreases the blood supply to the optic nerve which connects the eye to the brain. Damage can lead to visual field loss and even blindness.
• Uveitis: Uveitis (inflammation of the inner layer of the eye) is more common in smokers than non-smokers.
• Transient Ischemic Attack (TIA): Temporary vision loss (lasting few seconds to minutes) is often caused by transient ischemic attack. It is more commonly known as a TIA, or a “mini-stroke”.
• Pregnancy and Smoking: Smoking during pregnancy is associated with premature births and thus more risk of retinopathy of prematurity (incomplete development of the retina).

About the author- Dr. Soham Basak, MS, DNB, Consultant, Dept. of Cornea Services, Disha Eye Hospitals