Date Published: 1 May 2012

Professor of ophthalmology calls for blindness warnings on cigarettes

Andrew Lotery, a professor of ophthalmology at Southampton University, England, and consultant ophthalmologist at Southampton General Hospital has recently called for new health warnings on cigarettes to highlight smokers' increased risk of blindness. He also said genetic testing for age-related macular degeneration (AMD) – the leading cause of blindness in the western world – could help to reduce the number of smokers.

He spoke out after new research, published in journal Eye, which found less than half of patients in Southampton (47%) were aware of the link between smoking and eye disease, but more than two-thirds (67%) would be likely to or would definitely quit smoking if told they had a high genetic risk of developing age-related macular degeneration.

Smokers, in addition to being four times more likely to develop the condition compared to past or non-smokers, are further exposed if they have a high genetic risk factor and it is estimated smoking contributes to around 20% of blindness in people over the age of 50 years.

" While people are well aware smoking is a leading cause of cancer, respiratory problems and heart disease, there is little knowledge of its association with age-related macular degeneration and blindness" said Prof Lotery.

" Eye health has long been the victim of apathy within health services across the world and, in turn, this has led to the growth of a culture of neglect among individuals unaware of the consequences of their actions."

Age-related macular degeneratio, which can be either 'wet' or 'dry', occurs when the cells of the macula become damaged and stop working. Although wet macular degeneration can be stabilised using a new class of drugs called anti-VEGF agents, there is no cure or treatment for dry age-related macular degeneration, the most common form. See also the news item about Avastin and Lucentis equally effective for treating age-related macular degeneration.

More than three-quarters (75.5%) of participants said they would consider taking a genetic test for age-related macular degeneration, which affects one in three elderly people by the age of 75, but Prof Lotery said the need for more general guidance is the immediate priority among ophthalmologists.

" Although our primary aim was to discover whether or not knowledge of genetic risk for age-related macular degeneration could influence the motivation to quit smoking and to begin to investigate the advantages and disadvantages of routine genetic testing, it is clear there is a wider need to alert people of the link between smoking and blindness," he said.

" The immediate priority is to ensure all smokers, regardless of genetic factors, are aware of the dangers and I am calling for serious consideration of warnings on cigarette packets akin to those introduced in Australia in 2006 which led to a doubling of the number of requests to the country's quitters service within a year."

Prof Lotery identified a major new genetic association with AMD – SERPING1 – which is faulty in up to 25% of sufferers in 2008 and is currently working on the development of stem cell therapies to treat the condition.

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Source: Southampton University -

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