Comparison between Smokers and Nonsmokers regarding incidence of dry eye disease

Bekhit, Asmaa Elsayed Rasheed; Shohaeb, Essam Eldeen; Masoud, Mohamed Gamal

doi:10.21608/bmfj.2025.394489.2473

Comparison between Smokers and Nonsmokers regarding incidence of dry eye disease

Articles in Press

Document Type : Original Article

Authors

¹ M.B.B.Ch., Faculty of Medicine – Cairo University, Egypt

² Professor of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt

³ Assistant Professor of Ophthalmology, Faculty of Medicine, Benha University, Benha, Egypt

10.21608/bmfj.2025.394489.2473

Abstract

Purpose: Dry eye is a chronic inflammatory disorder of the ocular surface, induced by tear hyperosmolarity. Smokers have high risk of developing cataract compared to non-smokers and they are believed to complain of ocular surface symptoms more than non-smokers due to the irritant effect of smokers. This study intended to compare the incidence of dry eye between smokers and non-smokers of the 3rd and 4th decade, admitted to Ophthalmology Department, Benha University Hospitals.

Patients and methods: This prospective cohort study was made on 120 subjects, distributed into (smokers group) included 60 individuals with a history of cigarette smoking, between 30 to 50 years and (non-smokers group) involved 60 individuals without a history of cigarette smoking having matched age and sex.

Results: Patients in the smokers group demonstrated significantly higher frequencies of punctate epitheliopathy in both the right and left cornea (P < 0.001 for both). The Schirmer and TBUT values of both eyes among smokers were considerably less than non-smokers (P<0.001 for all). Smokers had ~28 and 140- fold increased risk of developing dry eye in the right and left eyes, respectively (P<0.001 for both). The multivariate linear regression analysis revealed that the smoking was significantly associated with reduced Schirmer and TBUT values in both eyes (P<0.001 for all).

Conclusion: Smoking significantly impairs tear production and stability, dramatically elevating the risk of dry eye disease. These findings highpoint the need for targeted smoking cessation strategies in ocular surface disease prevention.

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