_Dr Mohd Mizanur Rahman

The writer is a Research Fellow & Assistant Professor, Health Science Department of Management & Science University, Malaysia.

Smoking has long been known to cause heart disease and lung cancer however many people don’t realize that smoking can lead to vision loss. Tobacco smoke is a hazardous mixture of over 5,000 chemicals, many of which are toxic and potentially damaging to the eyes.

In a significant move towards public health awareness, Bangladesh has officially recognized the severe risks smoking poses to vision, acknowledging that smoking can lead to vision loss and even blindness. This development marks an essential step in the ongoing battle against tobacco-related health issues and underscores the need for heightened awareness and preventive measures.

Recent studies have shown a worrying link between smoking and serious eye problems, including vision loss and blindness. Many people know that smoking harms the lungs and heart, but fewer realize that it can also damage the eyes.

How Smoking Affects the Eyes

When you smoke, harmful chemicals enter your body and can affect your eyes in several ways.

Research has long established a strong correlation between smoking and various eye diseases. Smokers are significantly more likely to develop conditions such as age-related macular degeneration (AMD), cataracts, and diabetic retinopathy—all of which can lead to severe vision impairment or blindness.

Age-Related Macular Degeneration (AMD): AMD is a leading cause of vision loss in older adults. Smokers are up to four times more likely to develop AMD compared to non-smokers. The toxic chemicals in cigarettes damage the retina, the light-sensitive tissue at the back of the eye, leading to the gradual loss of central vision.

Cataracts: Smoking doubles the risk of developing cataracts, a condition characterized by the clouding of the eye`s lens, which impairs vision. This occurs because smoking generates free radicals that damage the lens proteins, leading to their clumping and forming a cataract.

Diabetic Retinopathy: Smoking exacerbates diabetes and its complications, including diabetic retinopathy. This condition involves damage to the blood vessels in the retina due to high blood sugar levels, leading to vision loss.

Optic neuropathy:  Optic neuropathy is damage to the optic nerve (which transmits visual information from the retina to the brain) from any cause. Anterior ischaemic optic neuropathy (AION) is a type of optic neuropathy which results in sudden, painless loss of vision, often leading to permanent blindness. Smoking might also play a role in the development of anterior ischaemic optic neuropathy. This is because smoking is a risk factor for the development of atherosclerosis, where plaques form within arteries, and this could lead to the optic nerve not receiving enough blood.

Glaucoma: Tobacco use increases the risk of open-angle glaucoma, a condition characterized by increased pressure within the eye that can damage the optic nerve, resulting in vision loss.

Uveitis: This is an inflammation of the uvea, the middle layer of the eye. Smoking increases the risk of uveitis, which can cause pain, redness, light sensitivity, and vision loss.

Dry Eye Syndrome: Dry Eye Syndrome is an eye disease that appears as damaged blood vessels in the eye. This can lead to eye irritation, itchy and scratchy eyes, and a burning sensation in the eyes.

Pregnant smokers and eye disease: Maternal smoking has been found to increase the risk of a number of eye defects in unborn children including: astigmatism (misshapen eyes), anophthalmia (absence of eye), microphthalmia (abnormally small eyes), strabismus (crossed eyes), esotropia (both eyes turned inwards), exotropia (eyes turned outwards) and optic nerve hypoplasia (underdeveloped or absent optic nerve)

Symptoms of Eye Diseases Related to Smoking

You may think your eyes are fine, but the only way to know for sure is by getting a full eye exam. AMD often has no early symptoms, so an eye exam is the best way to spot this eye disease early. An eye specialist will place special drops in your eyes to widen your pupils. This offers a better view of the back of your eye, where a thin layer of tissue (the retina) changes light into signals that go to the brain. The macula is a small part of the retina that you need for sharp, central vision.

• When symptoms of AMD do occur, they can include:5,6
• Blurred vision or a blurry spot in your central vision
• The need for more light to read or do other tasks
• Straight lines that look wavy
• Trouble recognizing faces

Public Health Implications

The government`s acknowledgment of these risks is crucial for several reasons. Firstly, it adds to the growing body of evidence highlighting the dangers of smoking, encouraging smokers to quit and deterring non-smokers from starting. Secondly, it paves the way for targeted public health campaigns to educate the populace about the specific risks smoking poses to vision.

Public health officials in Bangladesh are now tasked with integrating this information into existing anti-smoking initiatives. This includes updating warning labels on cigarette packages to include the risk of vision loss and blindness, launching awareness campaigns across media platforms, and incorporating this knowledge into educational programs.

Preventive Measures and Support

Preventing vision loss due to smoking is achievable through several strategies. Quitting smoking remains the most effective measure. Support systems such as smoking cessation programs, counselling, and nicotine replacement therapies are vital in helping individuals quit. Regular eye exams are also crucial, as they can detect early signs of eye disease, allowing for timely intervention.

Healthcare professionals are encouraged to discuss the risks of smoking with their patients, particularly focusing on the less commonly known danger of vision loss. Such discussions can significantly impact smokers` willingness to quit.

Protecting Your Eyes

The best way to protect your eyes from the harmful effects of smoking is to quit. Here are some steps you can take:

• Seek Support: Talk to your doctor about programs and medications that can help you stop smoking.
• Stay Informed: Learn about the benefits of quitting smoking and how it can improve your overall health.
• Regular Eye Check-Ups: Visit an eye doctor regularly for check-ups, especially if you are a smoker or have smoked in the past. Early detection of eye problems can prevent serious damage.

Conclusion

Bangladesh`s recognition of the link between smoking and vision loss is a progressive step towards protecting the nation`s eye health. As awareness spreads and preventive measures are implemented, it is hoped that the incidence of smoking-related vision impairment will decline. This development serves as a reminder of the myriad dangers smoking poses and reinforces the importance of continued efforts in tobacco control.

In conclusion, while the battle against smoking-related health issues continues, acknowledging the full spectrum of its dangers, including vision loss, represents a crucial victory for public health.

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