Clinical Study
Eye (2008) 22, 961–968; doi:10.1038/eye.2008.78; published online 18 April 2008
Alterations of the tear film and ocular surface health in chronic smokers
Y Matsumoto1, M Dogru2,3, E Goto4, Y Sasaki3, H Inoue5, I Saito5, J Shimazaki2 and K Tsubota3
- 1Department of Ophthalmology, Keio University School of Medicine, Tokyo, Japan
- 2J and J Department of Ocular Surface and Visual Optics, Keio University School of Medicine, Tokyo, Japan
- 3Department of Ophthalmology, Tokyo Dental College, Chiba, Japan
- 4Department of Ophthalmology, Tsurumi University School of Dental Medicine, Yokohama, Japan
- 5Department of Pathology, Tsurumi University School of Dental Medicine, Yokohama, Japan
Correspondence: M Dogru, J and J Ocular Surface and Visual Optics Department, Keio University School of Medicine, Shinanomachi 35 Shinjuku-ku, Tokyo, Japan. Tel: +81 3 5363 3820; Fax: +81 3 3359 8302; E-mail: muratodooru@ yahoo.com
Received 23 September 2007; Revised 19 February 2008; Accepted 19 February 2008; Published online 18 April 2008.
Abstract
Objective
To investigate the effects of chronic smoking on ocular surface and tear functions.
Methods
Fifteen right eyes of 15 healthy chronic smokers (9 men, 6 women; age range: 36–47 years) who smoked 20 cigarettes per day for 20 years and 20 eyes of 20 control non-smokers (12 men, 8 women; age range: 38–43 years) were included in this prospective study. All subjects underwent measurements of breath and haemoglobin CO concentration, tear lipid layer interferometry, evaporimetry, tear film break-up time (TBUT), Schirmer's I test, corneal fluorescein staining, conjunctival impression, and brush cytology.
Results
The mean Hb CO level was significantly higher in smokers compared to non-smokers. TBUT was also significantly shorter in smokers. Tear lipid layer showed significant slowing in spread over the tear film with a concomitant significant increase in tear evaporation rate. Conjunctival impression cytology revealed significant loss of goblet cells and squamous metaplasia in smokers. Brush cytology showed significant conjunctival neutrophil infiltration in smoker subjects.
Conclusion
Chronic smoking induced distinctive quantitative and qualitative disturbances on the ocular surface health.
Keywords:
dry eye, smoking, cytology, tear lipid layer
