The effect of smoking on the ocular surface and the precorneal tear film

BackgroundSmoking, both active and passive, creates a plethora ofhealth‐related problems, which primarily affect thecardiovascular and respiratory systems. There is very littleevidence on the effects of tobacco smoke on the eye,especially regarding anterior ocular surface relatedpathology. This study was undertaken to determine theeffects of smoking on the ocular surface and the tear film insmokers.MethodsA total of 51 (102 eyes) smokers and 50 (100 eyes) age‐ andgender‐matched healthy non‐smokers were included in thisstudy. The ocular surface was evaluated by measuring tearfilm break‐up time, surface staining with fluorescein, andcorneal and conjunctival sensitivities, and by completing theSchirmer’s II test. Data was analysed using StatisticalPackage for Social Sciences (SPSS) version 11.5. A p valueless than 0.05 was considered statistically significant.ResultsThe smoker group had significantly lower tear film break‐uptime, and corneal and conjunctival sensitivity than the nonsmokergroup. Punctate staining was significantly higher inthe smoker group than the non‐smoker group. There wasno statistically significant difference in Schirmer’s II testresults between the smoker and non‐smoker group.ConclusionSmoking caused adverse effects on the precorneal tear filmand there was strong association between smoking and tearfilm instability. Although a causative relationship could notbe determined, there is a need for further longitudinalstudies.