Clearing the Smoke: Does smoking affect Macular Degeneration?
The short answer, YES, A LOT! Smoking is the number one modifiable (things you can control) risk factor for macular degeneration. Not just increasing your risks of getting macular degeneration, but it also affects how early you will develop it, the severity, progression, and even one’s response to therapy. Let’s look at the facts.
If you currently smoke, you are up to 4X more likely to develop AMD. That is compared to people who have never smoked. With Wet AMD, the dreaded, blinding type, the risks are even higher. Former smokers are still hat a igher risk, but the risk declines. The longer you have not had a cig, the lower the risk of development. Notably, individuals who have remained nonsmokers for 20 years, the risk level is about the same as that of never smokers. Just like your lungs and your heart, over time your eyes heal.
Smoking Speeds Up Vision Loss
Smokers may develop AMD 5–10 years earlier than nonsmokers.
Smoking not only may cause you to develop AMD 5-10 years earlier than nonsmokers, it progresses faster too. That means you may initially develop early or intermediate dry AMD, but smokers are at higher risk of advancing sooner to late-stage AMD, including geographic atrophy and neovascular (wet) AMD. These advanced forms can result in significant and irreversible central vision loss.
Treatments aren’t as effective either. When a patient is diagnosed with Wet AMD, they are referred to a retinal specialist. The patient then receives injections of an anti-VEGF drug. Over the course of treatment, the goal is to reduce the swelling and fluid in the retina and regain the vision lost due to the leaky vessels. With smokers, the drug does not work as well, thus the disease progresses, and less vision is restored.
Why is smoking so bad for your eyes?
Tobacco smoke delivers over 7,000 chemicals, including heavy metals and oxidizing agents. This causes oxidative stress, which causes damage to your retina (specifically the mitochondrial DNA in the retinal pigment epithelium), reduces oxygen and nutrients to the macula (think blood flow), promotes drusen formation (the little waste baskets in the back of your eye), inflammation, and vessel damage (the cause of Wet AMD).
At Wise Eyes, we care about your vision.
Our app helps you monitor changes in your eyesight, spot early signs of macular degeneration, and share results with your eye care professional—all from your iPhone or iPad. Because protecting your eyes should be simple, smart, and in your hands.
References:
Thornton, J., Edwards, R., Mitchell, P., Harrison, R. A., Buchan, I., & Kelly, S. P. (2005). Smoking and age-related macular degeneration: a review of association. Eye, 19(9), 935–944.
Chakravarthy, U., Wong, T. Y., Fletcher, A., et al. (2006). Clinical risk factors for age-related macular degeneration: a systematic review and meta-analysis. BMC Ophthalmology, 6(1), 13.
Smith, W., Assink, J., Klein, R., et al. (2001). Risk factors for age-related macular degeneration: Pooled findings from three continents. Ophthalmology, 108(4), 697-704.
Velilla S, García-Medina JJ, García-Layana A, Dolz-Marco R, Pons-Vázquez S, Pinazo-Durán MD, Gómez-Ulla F, Arévalo JF, Díaz-Llopis M, Gallego-Pinazo R. Smoking and age-related macular degeneration: review and update. J Ophthalmol. 2013;2013:895147. doi: 10.1155/2013/895147. Epub 2013 Dec 4. PMID: 24368940; PMCID: PMC3866712
