Cigarette Smoking and Eye Diseases: A Comprehensive Review

Cigarette smoking remains a major global public health challenge, with the eye being particularly vulnerable due to its direct exposure to environmental insults. This review aims to synthesize epidemiological and mechanistic evidence linking traditional combustible cigarette smoking to a broad spectrum of ocular diseases.

A comprehensive literature search was conducted to identify studies examining the association between smoking and various ocular conditions, with a focus on epidemiological data and underlying pathological mechanisms.

Smoking is established as the strongest modifiable risk factor for age-related macular degeneration and is associated with a 10.8-fold increased risk of cataract development. It strongly predicts retinopathy onset after 9 years of diabetes duration. The reviewed evidence links diverse ocular diseases-from common conditions like dry eye and cataracts to less frequently discussed associations such as strabismus and amblyopia-to a unified set of pathological mechanisms centered on cigarette smoke-induced oxidative stress, chronic inflammation, neovascularization, and immune imbalance.

This review provides a comprehensive disease-to-mechanism panorama of smoking-related ocular damage. The findings underscore the critical importance of smoking cessation as a primary preventive strategy to mitigate the burden of avoidable vision loss.