Smoking

Cigarette smoking is one of the most significant modifiable risk factors for several serious eye diseases, particularly age-related macular degeneration (AMD) and cataracts. The toxins in tobacco smoke contain more than 7,000 chemicals that directly damage the delicate ocular tissues through a combination of oxidative stress, inflammation, and reduced blood flow.

Age-related macular degeneration, a leading cause of irreversible vision loss in older adults, is strongly linked to smoking. Research shows that smokers are two to four times more likely to develop AMD compared to non-smokers, and the risk increases with the number of cigarettes smoked and the total years of smoking. Smoking accelerates damage to the macula—the central part of the retina responsible for fine vision—by increasing free radicals, harming retinal pigment cells, and reducing protective antioxidants such as lutein and zeaxanthin. Even secondhand smoke raises the risk of AMD, and smokers tend to develop the disease at an earlier age. Importantly, quitting smoking can gradually reduce this risk, though it may take several years to approach that of a lifelong non-smoker.

Smoking is also a major contributor to cataracts, the clouding of the eye’s natural lens. Smokers have up to three times greater risk of developing nuclear cataracts, the most common age-related type. Tobacco smoke increases oxidative stress in the lens, damaging lens proteins and causing them to clump together, leading to vision-disturbing cloudiness. This process accelerates with both the duration and intensity of smoking.

Beyond AMD and cataracts, smoking is associated with an increased risk of dry eye disease, diabetic retinopathy progression, and optic nerve damage.

Quitting smoking is one of the most effective ways to protect long-term eye health. Vision saved is far easier than vision restored, and reducing tobacco exposure is a powerful step toward preventing avoidable blindness.