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Eye Health

Can cigarette smoking make glaucoma worse?

Ask the doctor

By , Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing
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An eye doctor speaks with a middle-age patient in an exam room with equipment visible in the foreground.

Q. How does smoking cigarettes affect glaucoma?

A. Smoking has a negative effect on several types of eye disease. But so far, medical studies have not proven a direct link between smoking and glaucoma.

Despite the lack of proof, most doctors recommend that people with glaucoma quit cigarettes. Here's why:

Pressure within the eye increases in people with glaucoma. Higher pressure is related to an increased risk of glaucoma-related vision loss.

Eye pressure is determined by measuring the amount of fluid in a chamber in the front part of the eye. This fluid is called aqueous humor. The eye continually produces new aqueous humor. Normally, eye pressure stays constant because the eye reabsorbs the same amount of fluid that it produces.

People with glaucoma have an imbalance in eye fluid movement and inadequate fluid absorption that leads to the rise in eye pressure.

One possible but unproven connection between smoking and glaucoma: Smoking causes blood vessels to tighten or constrict. When this happens, blood vessels in the eye have less capacity to reabsorb the aqueous humor. Logic suggests that eye pressure would therefore increase.

There is a definite association between smoking and an increased risk of developing cataracts and macular degeneration. So, even if smoking doesn't affect glaucoma, it's wise for people with glaucoma to avoid tobacco to reduce any risk of adding a second eye disease.

Image: © Zinkevych/Getty Images

About the Author

photo of Howard E. LeWine, MD

Howard E. LeWine, MD, Chief Medical Editor, Harvard Health Publishing; Editorial Advisory Board Member, Harvard Health Publishing

Dr. Howard LeWine is a practicing internist at Brigham and Women’s Hospital in Boston, Chief Medical Editor at Harvard Health Publishing, and editor in chief of Harvard Men’s Health Watch. See Full Bio
View all posts by Howard E. LeWine, MD
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