What’s Worse: High Myopia or Smoking?

Dr. Russel Lazarus, January 11, 2021

Smoking can lead to the development of sight-threatening eye diseases — but did you know that myopia can also increase your risk of these serious eye diseases? 

This article will explain why high myopia and smoking are both risk factors for ocular disease, as well as what you can do to protect your eye health and vision.


People with moderate to high myopia (above -3.00D) are five times more likely to develop cataracts at an earlier age. 

Cataracts occur when the eye’s naturally transparent lens becomes cloudy and opaque, making it difficult to see clearly.

Symptoms of cataracts include:

  • Blurry or cloudy vision
  • Increased sensitivity to glare
  • Seeing halos around lights
  • Poor night vision
  • Colors appearing less vibrant
  • Double vision

Studies show that increasing axial length in myopic eyes may prevent essential nutrients from reaching the back of the eye’s lens— which can lead to the development of a cataract.

Smoking can double your risk of developing cataracts at an earlier age. 

Smoking increases the amount of free radicals in your eyes. Free radicals are responsible for damaging the lipids and proteins in the eyes and causing deposits to form on the surface of the eye’s lens— leading to cataract development.

While the antioxidants you consume in your diet may help to fight the free radicals, smoking can actually kill off the antioxidants and produce toxins that lead to cataracts.

Macular degeneration (AMD)

People with high myopia (above −5.00 D) have an increased risk of developing macular degeneration.

High levels of myopia can lead to retinal damage and thinning of the macula, the center of the retina. This can cause the macula to tear and lead to bleeding underneath the retina, causing permanent central vision loss.

There are two different types of AMD:

Dry AMD causes gradual central vision loss, while wet AMD causes rapid central vision loss.

Symptoms of AMD include:

  • Distorted vision- lines appear wavy
  • Empty spots within central vision
  • Impaired color vision
  • Adjustment difficulties when moving between two areas that contain   different lighting (low light and bright light)

Cigarette smoke contains 4,700 toxic chemicals. These toxins can cause your retinal cells to age faster, and increase your risk of retinal thinning— putting your ocular health and vision at risk.

Smoking can increase your risk of developing AMD by up to 4 times.

Smoking causes your retinal blood vessels to constrict, which can increase your blood pressure and your risk of AMD.

Research also suggests that people who smoke have lower levels of the macular pigments lutein and zeaxanthin, which are responsible for protecting the macula from ultra violet (UV) radiation— another risk factor for AMD.

If you have myopia and smoke, contact an eye doctor near you who can discuss the best ways to ensure your eye health.

SEE RELATED: Top 5 Myopia Myths

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People with high myopia (above -5.00D) are 3 times more likely to develop glaucoma.

Glaucoma occurs when the fluid within the eye is unable to drain properly and the pressure within the eye rises. Overtime, the increased intraocular pressure (IOP) presses on the optic nerve and causes irreversible damage and permanent vision loss.

Symptoms of glaucoma include:

  • Severe eye pain
  • Blurred vision
  • Seeing halos around lights
  • Nausea and vomiting

As myopia progresses to higher levels, structural changes within the retina occur, causing the macula to thicken and increasing the risk of glaucoma.

Glaucoma can be caused by a number of risk factors, including high blood pressure, cataracts, and diabetes — all of which are closely linked to smoking.

Retinal detachment 

People with moderate myopia (above −3.00 D) are 10 times more likely to develop retinal detachment.

Retinal detachment can occur when fluid travels through a retinal tear and causes the retina to detach from the other tissues in the back of the eye.

Symptoms of retinal detachment are not always noticeable, but may include sudden vision loss or the presence of:

  • Sudden blurred vision
  • Floaters
  • Flashing lights
  • Shadows that block peripheral vision

High myopia can cause the retina to stretch and pull away from the tissues in the back of the eye.

Smoking more than doubles your risk of retinal detachment. 

Smoking increases inflammation in the body and the eyes. Swollen blood vessels are prone to breaking and leaking fluid. When the fluid leaks into the retina, retinal detachment can occur.

Additionally, the harmful chemicals found in cigarettes can cause uveitis, an inflammation of the uvea (the eye’s middle layer), which can lead to retinal detachment.

What can you do to protect your eye health and vision?

If your child has myopia, speak with your eye doctor about beginning a program of myopia management.

Myopia management is a program designed for children and teens with worsening myopia. Through the use of specialized lenses or eye drops, your eye doctor can effectively reduce the rate at which your child’s myopia is progressing and protect them from developing serious eye diseases in the future.

If you smoke, or live with someone who smokes, it is highly recommended to seek professional advice on how to quit. There are many different treatment programs that can help you kick your smoking habit to keep your eyes and body in optimal health.

Take your eye health seriously to avoid serious eye diseases in the future.

LEARN MORE: Guide to Pediatric Eye Conditions

If you have myopia and smoke, contact an eye doctor near you who can discuss the best ways to ensure your eye health.