This article on How Smoking Causes Vision Loss is aimed at providing educational information to the general public. It is not bespoke medical advice. As such, if you have any concerns about your eyes or vision, please seek an appointment with your optometrist.
We all know the major health warnings linked to smoking. For decades, we’ve been told about the risks of lung cancer and heart disease1. But there is another devastating consequence that remains dangerously overlooked: smoking and vision loss1,2,3. The link is not a vague possibility; it is a scientific certainty. Smoking is one of the single biggest preventable causes of irreversible blindness in the UK1.
The strange thing is, while losing our sight is one of our greatest fears, very few people are aware of this connection. One UK study found that only 5% of teenagers knew smoking could lead to blindness1,3. When I talk to my patients about it, their reaction is often shock. They know the other dangers, but the risk of smoking and vision loss is new to them.
This article is about closing that awareness gap. It’s about explaining exactly how smoking harms your eyes and, most importantly, what you can do to protect your precious sight.
How Does Smoking Harm Your Eyes?
It can be hard to imagine how something you inhale into your lungs can affect your eyes. I often explain it like this: when you breathe in, the air’s contents pass into your bloodstream through your lungs2,4. This is how the nicotine from a cigarette gives you that instant “hit.” But alongside the nicotine, between 70005 to 90004 other toxic chemicals, like tar5, carbon monoxide5, arsenic5, and formaldehyde5, also get a free ride into your bloodstream4.
This toxic cocktail then travels to every single part of your body4, including the delicate and complex structures of your eyes. These chemicals launch a two-pronged attack. Firstly, they starve your eyes of oxygen and essential nutrients by causing the tiny blood vessels to tighten and narrow6. Secondly, they unleash a process called “oxidative stress,”4,6,7 which is like an aggressive, accelerated rusting of the vital cells at the back of your eye7.
This combination of reduced blood supply and direct cellular damage is what leads to smoking and vision loss.
The Big Risks: Smoking’s Link to Major Eye Diseases
The damage caused by smoking isn’t just theoretical; it directly leads to some of the most serious eye diseases we see in our clinics.
Age-Related Macular Degeneration (AMD)2,3,7: This is the UK’s leading cause of irreversible blindness. It attacks your central vision, destroying your ability to see fine detail, read, drive, or recognise the faces of your loved ones. The link is undeniable: smokers are up to four times more likely to develop AMD than non-smokers. The more you smoke, the higher your risk.
Cataracts2,3: This is a progressive clouding of the natural lens inside your eye, making your vision misty and blurry2. While cataracts are treatable with surgery, smoking dramatically increases your chances of developing them. Smokers are two to three times more likely to get cataracts, and they often develop them at a much earlier age than non-smokers.
Glaucoma2: This disease damages the optic nerve, the vital “cable” that connects your eye to your brain. It typically causes a gradual loss of your peripheral (side) vision, which often goes unnoticed until the condition is advanced. While the link is more complex than with AMD, smoking is a significant risk factor as it can increase the pressure inside the eye2 and is known to damage the delicate blood supply that nourishes the optic nerve, making it more vulnerable to damage2.
These aren’t small risks. They are significant, life-altering consequences that directly link smoking and vision loss7.
Other Ways Smoking Affects Your Vision
The damage doesn’t stop with AMD and cataracts. The toxic chemicals in cigarette smoke contribute to a whole spectrum of other eye problems2.
Smokers are twice as likely to suffer from chronic Dry Eye Syndrome3, which causes constant irritation, grittiness, and discomfort.
For patients who already have diabetes, smoking acts as a dangerous accelerant, potentially worsening the damage to the blood vessels6 at the back of the eye – however, studies are undecided on this8.
It is also a major risk factor for developing Thyroid Eye Disease2,3 and uveitis, a painful inflammatory condition inside the eye.
The evidence is clear: from the front surface to the very back of the eye, smoking causes harm and increases your risk of smoking and vision loss.
The Best News: It is Never Too Late to Quit
After reading all of this, it would be easy to feel disheartened, but I want to end with a message of real hope. Quitting smoking is the single most important and effective thing you can do to reduce your risk of vision loss9.
The benefits to your body and your eyes start almost immediately. Many people I know who have successfully quit smoking say it was the best decision they ever made. They feel healthier10 and more energetic, they have more money10, and they feel an incredible sense of achievement from beating a tough addiction.
The science backs this up. Over time, an ex-smoker’s risk of developing significant eye disease can fall6 to almost the same level as someone who has never smoked11. It is never too late to make a positive change for your health and to protect your sight for the future.
How We Can Help: Your Path to Quitting
As optometrists, our primary concern is your well-being. That means looking after you as a whole person, not just a pair of eyes. When I ask a patient if they smoke, it’s not to judge them; it’s because I have a professional duty to explain the risks and offer support3. We can often see the early signs of damage during an eye exam, which can be a powerful motivator for change.
The great news is that there is more free, effective support available than ever before. Using a combination of behavioural support and cessation aids makes you up to four times more likely to quit successfully than relying on willpower alone. In the UK, the NHS offers fantastic services:
NHS England Smokefree
You can visit the website (nhs.uk/better-health/quit-smoking) to find a free Personal Quit Plan and a Quit Smoking app. You can call the Smokefree National Helpline on 0300 123 1044.
Help Me Quit Wales
This incentive in Wales helps you to connect with health care professionals that can help you quit, provide nicotine replacement therapy and organise access to prescription only medication for you. If you are in Wales, visit https://www.helpmequit.wales/. You can self-refer via phone too, by calling 0800 085 2219 or by texting HMQ to 80818.
Quit Your Way Scotland
Run by NHS 24, is a free and confidential stop smoking service. It can be accessed by a helpline 0800 84 84 84.
Stop Smoking NI
Provides signposting to over 600 local stop smoking services across Northern Ireland. They allow for free, one-to-one support with trained specialists over a 12-week programme. They can be found at www.stopsmokingni.info.
Local Stop Smoking Services
Your GP or local pharmacy can connect you with trained advisors for one-to-one support and access to nicotine replacement therapy. Some of these services may be signposted via the stop smoking initiatives described above.
Your optometrist can help you find these resources. We want to support you in making a change that will protect your sight for a lifetime.
Conclusion: Choose Sight Over Smoking
The link between smoking and vision loss is clear, powerful, and something everyone needs to be aware of. The thousands of chemicals in every cigarette cause direct and lasting damage to your eyes, dramatically increasing your risk of developing the very conditions that lead to irreversible blindness. But this is one cause of sight loss that you have the power to control. By choosing to quit, you are choosing to protect your sight. Don’t wait for a problem to arise.
Disclaimer: The information in this article is for general educational purposes and is not a substitute for personalised medical advice. If you have any concerns about your eyes or wish to discuss quitting smoking, please contact your local optometrist, GP, or pharmacist. Further articles for the general public and patients can be found here.
Frequently Asked Questions
Optometrists receive many questions about how smoking affects the eyes. This section covers a selection that are often asked.
How does smoking actually harm my eyes if I’m not putting smoke in them?
When you smoke, thousands of toxic chemicals enter your bloodstream through your lungs. These toxins then travel all over your body, damaging the tiny, delicate blood vessels in your eyes and starving them of essential oxygen and nutrients.
I’ve smoked for many years, is the damage already done?
While long-term smoking does cause damage, it is never too late to quit. Stopping smoking at any age can halt further harm and significantly reduce your future risk of developing serious, sight-threatening diseases.
I only smoke a few cigarettes a day. Is that still a risk?
Yes, unfortunately, there is no safe level of smoking. Every cigarette contributes to oxidative stress and damage to blood vessels. Your risk increases with the number of cigarettes you smoke and the number of years you’ve been a smoker.
Is vaping or using e-cigarettes bad for my eyes too?
The long-term effects of vaping are still being researched, but the nicotine in most e-liquids is known to restrict blood flow, which is not good for your eyes. The safest option for your eye health and overall health is to be completely free from both smoking and nicotine.
Can my smoking harm the eyes of my family and children?
Yes, research shows that regular exposure to secondhand smoke nearly doubles a non-smoker’s risk of developing Age-Related Macular Degeneration (AMD). By quitting, you protect not only your own sight but the sight of those you love.
What is the single biggest risk to my vision from smoking?
The biggest risk is Age-Related Macular Degeneration (AMD), the UK’s leading cause of irreversible blindness. Smokers are up to four times more likely to develop this devastating condition, which affects your central vision.
Will quitting smoking get rid of my cataracts?
Quitting won’t reverse a cataract that has already formed, as a cataract is a physical clouding of the lens. However, stopping smoking will dramatically slow down its progression and reduce your risk of needing surgery sooner.
Why do my eyes always feel so dry and irritated when I smoke?
This is a double-attack. The external smoke directly irritates the surface of your eye and breaks down your tear film, while the internal toxins you absorb can reduce the quality and quantity of the tears you produce.
How quickly will my eyes benefit after I stop smoking?
The benefits start right away as the oxygen levels in your blood improve and the immediate stress on your blood vessels is reduced. Over the long term, your risk of developing eye diseases continues to fall the longer you remain smoke-free.
Will my optometrist judge me if I tell them I smoke?
Absolutely not. Your optometrist is a healthcare professional who is there to help you, not judge you. Being honest allows them to give you the best possible advice and support to protect your health.
How can my optometrist help me quit smoking?
Your optometrist can explain the specific risks to your eyes, show you any early signs of damage which can be a powerful motivator, and guide you to the excellent, free NHS resources available to help you quit successfully.
My grandad smoked all his life and could see fine. Why is it a risk for me?
Genetics play a role, and some people are luckier than others. However, the scientific and statistical evidence is overwhelming; smoking hugely increases your personal risk, and there is no guarantee you will be as lucky.
Does this apply to cigars and pipes as well?
Yes. While the pattern of inhalation can be different, you still absorb nicotine and thousands of toxic chemicals into your bloodstream. Any form of tobacco use will increase your risk of developing smoking-related eye diseases.
Why haven’t I heard about the link between smoking and blindness before?
It’s a major public health blind spot that the eye care sector are working to change. While the link is scientifically proven, public awareness campaigns have historically focused on cancer and heart disease, but the message about vision loss is just as critical. That said, many packets now contain a graphic warning of the risk that smoking plays in sight loss.
Further Reading
- Moradi P, Thornton J, Edwards R, Harrison RA, Washington S, Kelly SP (2007). Teenagers’ perceptions of blindness related to smoking-novel message to a vulnerable group. British Journal of Ophthalmology 91(5): 605-607.
- Kulkarni A, and Banait S (2023). through the smoke: an in-depth review on cigarette smoking and its impact on ocular health. Cureus 15(10): e47779.
- Hoppe E (2007). The great optometric smokeout. Review of Optometry [Online.]. Available at: https://www.reviewofoptometry.com/article/the-great-optometric-smokeout [Accessed: June 28th 2025].
- Hahad O, Kuntic M, Kuntic I, Daiber A, and Münzel T (2023). Tobacco smoking and vascular biology and function: evidence from human studies. Pfügers Archiv – European Journal of Physiology 475: 797-805.
- Mendel JR, Baig SA, Hall MG, Jeong M, Byron MJ, Morgan JC, Noar SM et al. (2018). Brand switching and toxic chemicals in cigarette smoke: a national study. PLOS One [Online.] Available at: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0189928 [Accessed: 28th June 2025].
- Saz-Lara A, Martínez-Vizcaíno V, Sequí-Domínguez I, Álvarez-Bueno C, Notario-Pacheco B, and Cavero-Redondo I (2022). The effect of smoking and smoking cessation on arterial stiffness: a systematic review and meta-analysis. European Journal of Cardiovascular Nursing 21(4): 297-306.
- Yang W, Song C, Gao M, Wang S, Yu H, and Li Y (2022). Effects of smoking on the retina of patients with dry age-related macular degeneration by optical coherence tomography angiography. BMC Ophthalmology 22: 315.
- Wang B, Li H, Ma H, and Chen ZH (2024). The association of cigarette smoking with the development and progression of diabetic retinopathy: based on cross-sectional survey and mendelian randomization. Journal of Translational Medicine 22: 1169.
- College of Optometrists (no date). Smoking and your eyes. Look After Your Eyes [Online]. Available at: https://lookafteryoureyes.org/eye-care/smoking/ [Accessed: 28th June 2025].
- Macular Society (no date). Smoking and sight loss. Macular Society [Online.] Available at: https://www.macularsociety.org/support/daily-life/practical-guides/healthy-living/smoking/ [Accessed: 28th June 2025].
- NICE (2022). Macular degeneration – age-related: what are the risk factors? National Institute for Clinical Excellence [Online]. Available at: https://cks.nice.org.uk/topics/macular-degeneration-age-related/background-information/risk-factors/ [Accessed: June 28th 2025].
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