By Dr. Veena G.D., MBBS, DOMS 

When you are in the stress and it further escalates with the time factor of meeting a deadline or putting a presentation, you feel an intense urge to take a break. Mostly results in lighting a cigarette, but along with the release, up goes your vision very quietly. It is so quiet you will not know until it is lost. 

When you inhale cigarette smoke, thousands of toxins get into your blood circulation and reach all the parts of your body. These toxins cause damage to the macula (the most sensitive part of the retina, at the back of your eye). Tiny blood vessels can burst through the macula, leading to irreversible damage, or alternatively, the cells of the macula slowly die. Both ultimately lead to loss of vision.

It was also found that it was the amount smoked rather than whether someone had ever smoked that was critical. While regularly smoking a pack or more a day for 40 years almost tripled the risk of age related macular degeneration, the risks faced by non-smoking partners had nearly doubled. 

Cigarette smoking generally leads to cardiovascular disorder wherein it speeds up the development of atherosclerotic plaques (collections of cholesterol and fat), in the walls of arteries. These are like porridge, gradually blocking arteries so that blood flow becomes limited. Nicotine and carbon monoxide further damage the blood vessel by altering the vascular structure. The elasticity of the blood vessel are lost resulting in loss of blood supply to macula i.e ischemia or minute hemorrhages in the macular level. This hemorrhage in course of time will get organized as a scar tissue leading to permanent vision loss. Accordingly, there are two types of macular degeneration – Dry, resulting from loss of blood supply, and the other one is Wet, resulting from minute blood vessel damage and hemorrhage (leaking of blood through abnormal blood vessel). Apart from macular degeneration it further precipitates age related change in the eye like cataract, Glaucoma etc. 

The British Journal of Ophthalmology quotes that:

While smoking increased the risk of both types of macular degeneration (geographic atrophy and choroidal neovascularisation), giving up for 20 years or more cut the risk to levels comparable with those for non-smokers.

The average age that people present with age-related macular degeneration in the first eye is about 65 years. The second eye becomes impaired at a rate of about 12 percent each year and about 60 percent of patients are legally blind in both eyes by their 70th birthday. There is no effective medical or surgical cure for age-related macular degeneration, but rehabilitation advice helps people to live more independently. Small life style changes are advised wherein the stress factor which drives oneself towards smoking is diverted.

PPP – Points to Ponder before you take a Puff

• Smoking is the paramount contributing towards development of early age-related macular degeneration.
• There is no effective treatment for age-related macular degeneration.
• Quitting smoking, or not starting in the first place, is a way to ensure that good vision is maintained for as long as possible.