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May 16, 2022 | Cataracts

Does Smoking Make Cataracts Worse?

By Barrett Eubanks, M.D.

Does Smoking Make Cataracts Worse?

Want a reason to give up smoking? I'm sure you've already heard this before, but smoking can cause a wide variety of health issues. The most important health issues encountered by smokers involve the lungs and the cardiovascular system. But what about the eyes? Do you have to worry about cataracts if you smoke?

Smoking puts you at a higher risk of developing cataracts. Oxidative stress and toxins from smoking cause damage to our natural lens that builds up over time to cloud and blur our vision. Quitting smoking helps, but the risk from smoking will never completely go away.

Fortunately, if cataracts develop, surgery can take care of and treat the cataract - replacing the cataract with a new artificial lens. But prevention is always going to be an optimal solution.

Where Do Cataracts Come From?

Within our eyes is a natural lens. This lens gives us the ability to focus light in our eye. The lens actually is made up of multiple stacked lens cells. These cells are transparent giving us great clear vision.

With age, however, the proteins and cell components start to break down. As their structure changes, these proteins lose their transparency. The lens starts to scatter and block light from reaching to the back of the eye. When enough of this occurs, vision becomes blurry and the lens is now called a cataract.

There are a variety of ways the lens proteins can break down and cause cataracts. For example, increased swelling within the lens or impaired delivery of nutrients to the lens can make the lens cells "sick" and create cataracts. There are a variety of different types of cataracts that are caused by these different mechanisms.

But the most common type of cataract just happens with age. This particular type of cataract, called a nuclear sclerosis cataract, develops slowly and progressively over time blurring vision. This leads the lens to develop a yellow to dense brown coloration.

In nuclear sclerotic cataracts, the lens proteins break down through time due to natural aging. But there are things which can speed up the development of these age-related cataracts. One such thing is stress from oxidation. This oxidation breaks down the proteins in the lens and makes it cloudy.

The Damage From Smoking

What is one thing that promotes oxidative stress? You guessed, it smoking. Smoking leads to oxidative stress. This happens from unstable and reactive molecules within the smoke as well as the inflammation that smoking causes. This oxidative stress is also the reason why smoking leads to cardiovascular problems as this oxidation damages the blood vessels within the body. But this oxidative stress will also cause long-term damage to the lens forming cataracts.

But oxidation isn’t the only concern. Toxins from cigarette smoke can make their way into the lens. As the name implies, toxins are toxic. As these build up in the lens, these too can encourage cataract formation.

So What’s The Risk?

As the damage from smoking is cumulative, the longer you smoke the more damage that occurs. Smokers can be divided into two main categories. Those that are current smokers and those that are past smokers. In general, current smokers are more likely to have a longer history of smoking than past smokers (since current smokers are still smoking). Because of this current smokers are at the greatest risk of cataracts.

In fact, current smokers have an almost 50% risk of developing cataracts when compared to non-smokers! And that’s quite a high number for something that can be changed.

Current smokers even have a higher risk than past smokers. Which brings us to our next question:

Does Quitting Smoking Help?

Given the fact that the risk goes down between current smokers and past smokers, quitting absolutely will help prevent further lens damage and the risk of cataracts. After quitting smoking, the risk of developing cataracts actually decreases. But while the risk goes down, it doesn’t decrease to the same levels as someone who has never smoked (but still enough of a reason to quit smoking)

What’s the take-away?

  • If are a current smoker, your risk of developing cataracts is much greater than the population. The best thing you can do for your eyes (and also your overall health) is to quit smoking. But of course easier said than done. Talk to your doctor about options to quit smoking, look into nicotine replacement therapy or check out online resources.
  • If you already quit smoking, congrats! That’s a big move that is sure to have a huge impact on your health. You will decrease your risk of developing cataracts (not to mention all the other health benefits).
  • If you don’t smoke, DON’T start. Smoking will cause some irreversible damage and is just best avoided.

While it’s always best to prevent cataracts from occurring, fortunately it isn’t the end of the world if they do happen. Cataracts will happen to just about everyone at some point in their life if they live long enough. And cataracts can be treated very effectively with cataract surgery. Cataract surgery removes the cataract and replaces it with an artificial lens instead. And as successful as cataract surgery is, prevention is always going to be the best option. Nobody wants to need cataract surgery at a young age.

Summary

Smoking increases the risk of cataracts by causing oxidative stress and damage to the natural lens in our eye. Quitting smoking can decrease the risk of developing cataracts but it can’t eliminate the risk. So take the step to quit today to keep your vision as healthy as possible.

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