Eye Health Up In Smoke

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When smoke gets in the eyes, its irritating sting may be the least of your clients worries. When they puff on a cigarette, that curling plume of acrid smoke might well signal smouldering eye disease that could literally rob them blind.
Tobacco smoke damages blood vessels in the eye. Toxic chemicals in smoke transform nutrients that feed the eyes and disrupt eye chemistry.
Smoking causes a litany of serious eye diseases that most people don’t know about.
Smokers are three times more likely to develop age-related macular degeneration, a disease that damages the central area of the retina, creating a blind spot or distortions in central vision. It can steal the ability to drive, to perform fine detail work or to see your loved ones.
Macular degeneration is Canada’s leading cause of vision loss.
Although the degenerative progress of the disease can be stalled there is no cure.
“Age related macular degeneration is hard to treat. In most cases, you can’t treat it,” says Dr. Ryan Kennedy, a scientist at the Propel Centre for Population Health Impact at the University of Waterloo.
People who smoke a pack of cigarettes a day are two to three times more likely to develop cataracts than non-smokers. Cataracts cloud the lens in eye, causing blurry vision, changes in colour perception and sensitivity to glare.
“The toxic elements in cigarette smoke destroy the antioxidant nutrients that are essential to lens transparency,” says Dr. Victor Malinovsky, clinical professor in the School of Optometry at Indiana University.
Smoking damages blood vessels that supply the optic nerve, increasing the risk of glaucoma, the second most common cause of blindness. It is also linked to sudden blindness caused by ischemic optic neuropathy.
“You can wake up and your vision is gone, or half your field of vision is gone,” warns Dr. Malinovsky.
While tobacco’s effects on vision and ocular health are huge, public awareness is not. Researchers at the University of Waterloo reported in 2011 that fewer than 10 per cent of people know that smoking causes sight-threatening eye disease. They found a variety of tobacco prevention and cessation programs across Canada, but none that included any information or explicit content about eye disease caused by smoking. Ask a public health unit for information about smoking and blindness and you’re likely to get very little.
Optometrists, on the front lines of sustaining healthy vision, are usually the first to detect tobacco’s effects on eye sight. These professionals are now getting help to change the public’s paltry perception of this health problem.
Health Canada introduced its first cigarette package warning linking smoking to blindness in 2012.
The picture shows eyelids retracted to expose an eyeball and a hypodermic needle inserted into the eye.
“It’s certainly a catchy image,” says Dr. Kennedy, who has coauthored several papers about smoking, healthy vision and optometry. He’s optimistic the new warning label has already increased public knowledge about the link between smoking and eye disease.
Most smokers know smoking causes lung cancer, heart disease and stroke. But while their knowledge of the link between tobacco and eye disease is low, their fear of blindness is not. British studies found teens fear blindness more than lung cancer, heart disease and stroke.
“Going blind is a very easy thing to understand,” says Dr. Kennedy. “We can all understand what our lives would be like if we were blind.”
That fact may give health practitioners an edge in helping people quit smoking. Cigarette package warnings and studies about smoking and eye health might help prevent people from starting to smoke, Dr. Kennedy predicts.
Optometrists are good at health education and their service model allows time for counselling, more than many other health professionals,
Dr. Kennedy says. This summer a new continuing education program at the University of Waterloo will show eye care professionals how to support patients who want to quit smoking.
“We need to get the tools to eye care professionals so that it makes these conversations and discussions easier,” Dr. Kennedy says.
Health specialists will learn more than just the medical statistics about smoking, they’ll learn about people who smoke and what will potentially help them to quit.
“They need to know about cessation services and how effective they are. They need to be able to answer questions,” Dr. Kennedy says.
Organizers hope to put the program on line and make it accessible to optometrists and other health care providers across Canada.

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