To provide a comprehensive synthesis of the available evidence on the effects of smoking on ocular health.
Methods
Databases (PubMed, SCOPUS, Web of Science) were searched through December 2024 for systematic reviews and meta-analyses on smoking and ocular disease risk. Meta-analysis quality was assessed using the 16-item A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2.
Results
Sixteen studies were included, with 12 qualifying for meta-meta-analysis. Current smokers are 7 to 12 times more likely to develop AMD than non-smokers (Odds Ratio [OR]: 11.93 [95% CI 4.40 to 32.33]; Risk Ratio [RR]: 7.45 [95% CI 4.09 to 13.57]). Past smokers have a seven-fold increased risk (OR: 7.09 [95% CI 4.79 to10.51]). For POAG, current smokers have three times the risk (OR: 3.07 [95% CI 2.07 to 4.54]), and past smokers have three times the risk (OR: 2.64 [95% CI 2.33 to 3.00]). Current smokers are four times more likely to develop cataracts (OR: 4.15 [95% CI 3.35 to 5.15]), while “ever” smokers face a six-fold risk (OR: 5.96 [95% CI 3.21 to 11.04]).
Conclusion
Smoking is a modifiable risk factor for numerous ocular diseases. Public health efforts and clinical guidelines should emphasize smoking cessation to reduce smoking-related ocular disease incidence and promote ocular health.
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