Chronic smoking linked to dry eye signs and reduced RNFL thickness
A case-control study evaluated the effects of long-term smoking on dry eye disease (DED) indicators and retinal nerve fiber layer (RNFL) thickness in adults.
The analysis included 100 eyes from 50 participants aged 30 to 60 years, evenly divided between non-smokers and chronic smokers who reported smoking ≥1 pack per day for 10 years or longer.
All participants underwent comprehensive ophthalmic assessment, including the Ocular Surface Disease Index (OSDI) questionnaire, non-invasive tear film breakup time (NIBUT), tear meniscus height, lipid layer thickness, and RNFL measurements using Fourier-domain OCT.
Compared with non-smokers, smokers had significantly higher OSDI scores, shorter NIBUT, and thinner lipid layers, indicating worse ocular surface status. RNFL thickness was also significantly lower in smokers, particularly in the superior temporal, inferior temporal, temporal upper, and nasal upper regions, as well as in average RNFL thickness.
Longer smoking duration and higher pack-years were strongly associated with higher OSDI scores and were inversely correlated with temporal upper RNFL thickness.
The study concluded that chronic smoking is associated with measurable changes in both tear film parameters and RNFL thickness, affecting ocular surface health and specific retinal regions.
Reference
Wanees Nakhla MT, El Din Shalash AB, Edris NA, et al. Assessment of dry eye disease and retinal nerve fiber layer thickness in chronic smokers. Cont Lens Anterior Eye. 2026;49(2):102602. doi: 10.1016/j.clae.2025.102602. Epub ahead of print. PMID: 41483742.
