Korean J Ophthalmol.  2005 Mar;19(1):18-22. 10.3341/kjo.2005.19.1.18.

Effects of Smoking on Tear Film and Ocular Surface

• Yoon KC
• Song BY
• Seo MS

• KMID: 1099080
• DOI: http://doi.org/10.3341/kjo.2005.19.1.18

Abstract

This study was performed to evaluate the changes of tear film and ocular surface caused by smoking. Symptom scoring, tear film break-up time (BUT), basal tear secretion test, corneal sensitivity test, keratoepitheliopathy scoring, and conjunctival impression cytology were performed in 29 smokers (58 eyes) and 26 non-smokers (52 eyes). Tear film BUT, basal tear secretion, corneal sensitivity, and squamous metaplasia were 7.71 +/- 2.66 sec, 6.29 +/- 2.85 mm, 53.69 +/- 5.69 mm, and 2.45 +/- 1.26 in smokers and 9.62 +/- 3.14 sec, 10.04 +/- 3.87 mm, 56.46 +/- 4.79 mm, and 1.12 +/- 0.83 in non-smokers, respectively (p< 0.05). Symptom score, keratoepitheliopathy score, and goblet cell density were not significantly different between the two groups. Tear film BUT was shorter, basal tear secretion and corneal sensitivity were lower, and squamous metaplasia was higher in heavy smokers than in light smokers. In conclusion, smoking deteriorates the tear film and ocular surface with decreased quantity and quality of tear film, decreased corneal sensitivity, and squamous metaplasia, and this deterioration is related to the amount of smoking.

Keyword

Ocular surface; Smoking; Tear film

MeSH Terms

Adult
Aged
Cell Count
Conjunctiva/*metabolism/pathology
Cornea/*metabolism/pathology
Epithelial Cells/pathology
Goblet Cells/metabolism/pathology
Humans
Lacrimal Apparatus/*metabolism/physiopathology
Male
Metaplasia
Middle Aged
Smoking/*metabolism/physiopathology
Tears/chemistry/*secretion

Figure

• 

  Fig. 1 Impression cytology (PAS, ×400). (A) Specimen from a nonsmoker shows PAS positive goblet cells and small, round epithelial cells with a nucleocytoplasmic ratio of 1:2. (B) Specimen from a heavy smoker shows a loss of goblet cells and large, polygonal epithelial cells with a nucleocytoplasmic ratio of 1:6.

Reference

1. Solberg Y, Rosner M, Belkin M. The association between cigarette smoking and ocular diseases. Surv Ophthalmol. 1998. 42:535–547.

2. Seddon J, Fong D. Introducing "Public health and the eye". Surv Opthalmol. 1994. 38:325.

3. Cheng ACK, Pang CP, Leung ATS, et al. The association between cigarette smoking and ocular disease. Hong Kong Med J. 2000. 6:195–202.

4. Cometto-Muniz JE, Cain WS. Sensory irritation. Relation to indoor air pollution. Ann N Y Acad Sci. 1992. 641:137–151.

5. Satici A, Bitiren M, Ozardali I, et al. The effects of chronic smoking on the ocular surface and tear characteristics: a clinical, histological and biochemical study. Acta Ophthalmol Scand. 2003. 81:583–587.

6. Dogru M, Katakami C, Inoue M. Tear function and ocular surface changes in noninsulin-dependent diabetes mellitus. Ophthalmology. 2001. 108:586–592.

7. Jones LT. The lacrimal secretory system and its treatment. Am J Ophthalmol. 1966. 62:47–60.

8. Miyata K, Amano S, Sawa M, Nishida T. A novel grading method for superficial punctate keratopathy magnitude and its correlation with cornea epithelial permeability. Arch Ophthalmol. 2003. 121:1537–1539.

9. Nelson JD. Impression cytology. Cornea. 1988. 7:71–81.

10. Moss SE, Klein R, Klein BE. Prevalence of and risk factors for dry eye syndrome. Arch Ophthalmol. 2000. 118:1264–1268.

11. Weislander G, Lindgren T, Norback D, Venge P. Changes in the ocular and nasal signs and symptoms of aircrew in relation to the ban on smoking on intercontinental flights. Scan J Work Environ Health. 2000. 26:514–522.

12. Avunduk AM, Avunduk MC, Evirgen O, et al. Histopathological and ultrastructural examination of the rat conjunctiva after exposure to tobacco smoke. Ophthalmologica. 1997. 211:296–300.

13. Sen DK, Sarin GS. Biological variations of lysozyme concentration in the tear fluids of healthy persons. Br J Ophthalmol. 1986. 70:246–248.

14. Grus FH, Sabuncuo P, Augustin A, Pfeiffer N. Effect of smoking on tear protein. Graefes Arch Clin Exp Ophthalmol. 2002. 240:889–892.

15. Gabela Merino M, Gonzalez Garcia MJ, Mayo Iscar A, Calonge Cano M. Dry eye signs and symptoms in hydrogel contact lens wearers: relation to smoking habit. Arch Soc Esp Oftalmol. 2003. 78:543–548.

16. Kjaergaard SK, Pederson OF. Dust exposure, eye redness, eye cytology, and mucous membrane irritation in a tobacco industry. Int Arch Occup Environ Health. 1989. 61:519–525.