Does smoking make AMD worse?

The World Health Organisation (WHO) is holding No Tobacco Day on May 31st. To mark it, we are investigating how smoking affects those with age-related macular degeneration (AMD).

If you’re one of the 700,000 people in the UK living with AMD-related sight loss, then you’ll understand exactly how this condition impacts everyday life. If you have signs of AMD or if you’re at risk of developing the condition, it's important to take every possible step to prevent any deterioration in your vision.

With research showing smoking as a risk factor for AMD and the WHO raising awareness of how tobacco can impact people’s health, this article will establish the facts about smoking and AMD.

Facts about smoking and AMD

Four million people are estimated to be living with signs of AMD by the Royal National Institute of Blind People (RNIB). Caused by the deterioration of a group of cells called the macular in the retina at the back of the eye, AMD has a range of risk factors.

These risk factors include:

  • Age, due to the reduction in cell regeneration as we get older
  • Genetics, with those who have a family history of AMD being more at risk
  • Diet, with the antioxidants and nutrients from fruit and vegetables being key to staying healthy
  • Blood pressure, with high levels putting extra pressure on the eyes
  • Smoking is also a major risk factor, both for those that have a genetic predisposition and those that don’t. Research cited by the Macular Society provides a range of statistical evidence for this, including:

  • Current smokers are up to four times more likely to have AMD than non-smokers
  • Smokers are more likely to develop AMD 10 years earlier than non-smokers
  • Smokers with a genetic predisposition (mutations in the HTRA1 gene) are 20-times more likely to get AMD than non-smokers
  • One-third of all AMD is thought to be caused by the combination of genetics and smoking
  • Second-hand smoke is also likely to increase AMD risk
  • In short, smoking has been found to contribute towards a deterioration in eye health and can be a risk factor for developing AMD.

    How does smoking affect those with AMD?

    Smoking tobacco exposes people to thousands of toxic chemicals and substances. These chemicals then pass through the front of the eyes and into the bloodstream. Once they reach the body’s cells, they disrupt their metabolism by releasing more ‘free radicals’, reducing the flow of oxygen and preventing them from regenerating. Free radicals are unstable atoms that can damage cells, causing illness and ageing.

    Free radicals are also thought to reduce the levels of lutein, a substance that is naturally found in the macular. Additionally, the tar from cigarettes can lead fatty deposits to form on the retina and cause AMD symptoms to worsen. Substances from cigarettes can also damage blood vessels, including those in the retina.

    People living close to smokers can be affected by these just as much as smokers themselves. Plus, even if smokers or those living with them have a healthy lifestyle, such as a diet high in antioxidants, the chemicals in cigarettes can negate its otherwise positive effects.

    In short, smoking tobacco can increase the likelihood of developing AMD in smokers and those exposed to the chemicals it releases.

    What do eye care professionals advise?

    Due to the damage chemicals released by smoking tobacco cause to the eyes, professionals recommend that people stop completely, particularly if they have other risk factors. As Phillip Moradi, Consultant Ophthalmologist and Research Fellow at the University College London explains, “Smoking prevention in school children and adults is the most effective way to reduce AMD and devastating visual loss.”

    Even if smokers aren’t at risk of AMD, eye care professionals say stopping smoking is the best way to prevent the development of many eye conditions. Consultant Ophthalmologist, Simon Kelly FRCOphth, says, “Although smoking is associated with several eye diseases… the most common cause of smoking-related blindness is AMD.”

    Plus, people already living with AMD are encouraged to quit smoking. This will help to slow the progression of the condition, including increased sight loss.

    How can people with AMD quit smoking?

    Quitting smoking isn’t easy but essential if those living with AMD are going to protect their sight for as long as possible. Choosing the right methods and steps to quitting is also key to helping smokers cut down successfully.

    To get professional advice and support, smokers are encouraged to:

  • Access tools via the NHS Smokefree website
  • Speak to a trained Quit counsellor or get help at Quitline
  • Get information at the BHF No Smoking Day website
  • Plus, by accessing the new free OcuPlan service, people living with AMD and their loved ones can get the support and professional advice they need. This includes information on how to lead a healthy lifestyle and slow the condition’s progression, including stopping smoking.

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