Review of Optometry
Practice Pearl of the Week
Volume 1, Number 9
June 28, 2010

Welcome to Review of Optometry's Practice Pearl of the Week series. Optometrist Paul Karpecki will provide you invaluable clinical information and management strategies for a host of ocular conditions—from dry eye and corneal infection to retinal artery occlusion and neuro-ophthalmic disease.

Is there a relationship between uveitis and smoking tobacco?

Although it is considered more common for an internist, family doctor, cardiologist or pulmonologist to advise patients not to smoke tobacco, it is also our job as primary eye care providers to educate patients about smoking cessation.

In addition to the obvious systemic hazards, smoking is a risk factor for several common ocular conditions, including AMD and cataracts. However, many clinicians may not know that there is one other ocular pathology directly associated with smoking—uveitis. In fact, if a patient with a history of smoking presents with recurrent iritis, you should advise him or her that smoking may be a key-contributing factor to their chronic inflammation.

In March 2010, Phoebe Lin, M.D., Ph.D., and associates published an article in Ophthalmology that reviewed the case histories of 564 patients who were diagnosed with iritis during an eight-year period.¹ Upon comparing the patient data to equal subsets, the researchers determined that patients with a history of cigarette smoking were 2.2 times more likely to develop uveitis than patients who did not smoke. They also noted a higher incidence of panuveitis and cystoid macular edema in patients who smoked.

Sometimes, our patients are not aware of all of the conditions that potentially could be related to smoking. However, your recommendation to quit smoking ultimately could motivate your patients to break their habit and prevent major systemic and/or ocular disease.


1. Lin P, Loh AR, Margolis TP, Acharya NR. Cigarette smoking as a risk factor for uveitis. Ophthalmology. 2010 Mar;117(3):585-90.


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