Skip to main content
SpringerLink
Log in

The impact of vaping on ocular health: a literature review

International Ophthalmology volume 41, pages 2925–2932 (2021)Cite this article

Abstract

Purpose

Vaping, or the use of electronic cigarettes, was initially introduced as a step toward smoking cessation, but has become an increasingly popular option for smokers. Though advertised as safer than conventional cigarettes, these devices have been found to contain carcinogenic chemicals, air pollutants, and heavy metals. The purpose of this article is to shed light on the known effects of vaping on the ocular setting and raise the discussion about additional potential effects that may call for further investigation.

Methods

A comprehensive literature search was conducted for publications pertaining to the effects of vaping on the eye. Relevant studies and findings were summarized in this article.

Results

It was found that aldehydes and free radicals present in electronic cigarettes may induce a disturbance in tear film stability, and vape flavorings may damage the lipid layer through peroxidation. Corneal staining has been shown to appear following exposure to e-cigarette vapor, with nicotine and acrolein potentially inducing an inflammatory response in corneal epithelial cells. In addition, nicotine has been shown to induce nystagmus, exert vasoconstrictive effects on ocular blood flow, and may interfere with retinal light-adapted vision. Vape-related explosions, though unpredictable, may also result in decreased visual acuity along with long-term ocular trauma.

Conclusion

Research discussing both the short-term and long-term effects of vaping on the eye is limited. However, the potential harms of substances such as nicotine and aldehydes warrant additional investigation and increased education about the detriment that electronic cigarettes may inflict on sensitive organs.

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

USD 39.95

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Fig. 1
Fig. 2

References

  1. Yamin CK, Bitton A, Bates DW (2010) E-cigarettes: a rapidly growing Internet phenomenon. Ann Intern Med 153(9):607–609. https://doi.org/10.7326/0003-4819-153-9-201011020-00011

    Article  PubMed  Google Scholar 

  2. WHO global report on trends in prevalence of tobacco smoking 2000–2025, 2nd edn

  3. Wang TW, Gentzke AS, Creamer MR et al (2019) Tobacco Product Use and Associated Factors Among Middle and High School Students—United States, 2019. MMWR Surveill Summ 68(12):1–22. https://doi.org/10.15585/mmwr.ss6812a1

  4. Hallagan J (2014) The Safety Assessment and Regulatory Authority to Use Flavors: Focus on E-Cigarettes | FEMA. Retrieved from https://www.femaflavor.org/node/24344 (May, Accessed 10 June 2015)

  5. Dawkins L, Turner J, Roberts A, Soar K (2013) “Vaping” profiles and preferences: an online survey of electronic cigarette users. Addiction 108(6):1115–1125. https://doi.org/10.1111/add.12150

    Article  PubMed  Google Scholar 

  6. Wang TW, Marynak KL, Agaku IT, King BA (2017) Secondhand exposure to electronic cigarette aerosol among US youths. JAMA Pediatr 171(5):490–492. https://doi.org/10.1001/jamapediatrics.2016.4973

    Article  PubMed  Google Scholar 

  7. Hua M, Talbot P (2016) Potential health effects of electronic cigarettes: a systematic review of case reports. Prev Med Rep 4:169–178. https://doi.org/10.1016/j.pmedr.2016.06.002

    Article  PubMed  PubMed Central  Google Scholar 

  8. Galor A, Lee DJ (2011) Effects of smoking on ocular health. Curr Opin Ophthalmol 22(6):477–482. https://doi.org/10.1097/ICU.0b013e32834bbe7a

    Article  PubMed  Google Scholar 

  9. Uchino Y, Uchino M, Yokoi N et al (2016) Impact of cigarette smoking on tear function and correlation between conjunctival goblet cells and tear MUC5AC concentration in office workersImpact of cigarette smoking on tear function and correlation between conjunctival goblet cells and tear MUC5AC concentration in office workers. Sci Rep 6:27699. https://doi.org/10.1038/srep27699

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Matsumoto Y, Dogru M, Goto E et al (2008) Alterations of the tear film and ocular surface health in chronic smokers [published correction appears in Eye. Eye (Lond) 22(7):983, 22(7):961–968. https://doi.org/10.1038/eye.2008.78

  11. Rummenie VT, Matsumoto Y, Dogru M et al (2008) Tear cytokine and ocular surface alterations following brief passive cigarette smoke exposure. Cytokine 43(2):200–208. https://doi.org/10.1016/j.cyto.2008.05.011

    Article  CAS  PubMed  Google Scholar 

  12. Md Isa NA, Koh PY, Doraj P (2019) The tear function in electronic cigarette smokers. Optom Vis Sci 96(9):678–685. https://doi.org/10.1097/OPX.0000000000001422

    Article  PubMed  Google Scholar 

  13. Kosmider L, Sobczak A, Fik M et al (2014) Carbonyl compounds in electronic cigarette vapors: effects of nicotine solvent and battery output voltage. Nicotine Tob Res 16(10):1319–1326. https://doi.org/10.1093/ntr/ntu078

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Goel R, Durand E, Trushin N et al (2015) Highly reactive free radicals in electronic cigarette aerosols. Chem Res Toxicol 28(9):1675–1677. https://doi.org/10.1021/acs.chemrestox.5b00220

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Martin EM, Clapp PW, Rebuli ME et al (2016) E-cigarette use results in suppression of immune and inflammatory-response genes in nasal epithelial cells similar to cigarette smoke. Am J Physiol Lung Cell Mol Physiol 311(1):L135–L144. https://doi.org/10.1152/ajplung.00170.2016

    Article  PubMed  PubMed Central  Google Scholar 

  16. Wang P, Chen W, Liao J et al (2017) A device-independent evaluation of carbonyl emissions from heated electronic cigarette solvents. PLoS One 12(1):e0169811. https://doi.org/10.1371/journal.pone.0169

  17. Sleiman M, Logue JM, Montesinos VN et al (2016) Emissions from electronic cigarettes: key parameters affecting the release of harmful chemicals. Environ Sci Technol 50(17):9644–9651. https://doi.org/10.1021/acs.est.6b01741

    Article  CAS  PubMed  Google Scholar 

  18. Goniewicz ML, Knysak J, Gawron M et al (2014) Levels of selected carcinogens and toxicants in vapour from electronic cigarettes. Tob Control 23(2):133–139. https://doi.org/10.1136/tobaccocontrol-2012-050859

    Article  PubMed  Google Scholar 

  19. Geiss O, Bianchi I, Barrero-Moreno J (2016) Correlation of volatile carbonyl yields emitted by e-cigarettes with the temperature of the heating coil and the perceived sensorial quality of the generated vapours. Int J Hyg Environ Health 219(3):268–277. https://doi.org/10.1016/j.ijheh.2016.01.004

    Article  CAS  PubMed  Google Scholar 

  20. Choi W, Lian C, Ying L et al (2016) Expression of lipid peroxidation markers in the tear film and ocular surface of patients with Non-Sjogren Syndrome: potential biomarkers for dry eye disease. Curr Eye Res 41(9):1143–1149. https://doi.org/10.3109/02713683.2015.109870

    Article  CAS  PubMed  Google Scholar 

  21. Bitzer ZT, Goel R, Reilly SM et al (2018) Effect of flavoring chemicals on free radical formation in electronic cigarette aerosols. Free Radic Biol Med 120:72–79. https://doi.org/10.1016/j.freeradbiomed.2018.03.020

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  22. Munsamy A, Bhanprakash B, Sirkhot A et al (2019) A pre-test post-test assessment of non-invasive keratograph break up time and corneal epithelial thickness after vaping. Afr Health Sci 19(4):2926–2933. https://doi.org/10.4314/ahs.v19i4.13

    Article  PubMed  PubMed Central  Google Scholar 

  23. Lerner CA, Sundar IK, Yao H et al (2015) Vapors produced by electronic cigarettes and e-juices with flavorings induce toxicity, oxidative stress, and inflammatory response in lung epithelial cells and in mouse lung. PLoS One 10(2):e0116732. https://doi.org/10.1371/journal.pone.0116732

  24. Cervellati F, Muresan XM, Sticozzi C et al (2014) Comparative effects between electronic and cigarette smoke in human keratinocytes and epithelial lung cells. Toxicol In Vitro 28(5):999–1005. https://doi.org/10.1016/j.tiv.2014.04.012

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  25. Rowell TR, Reeber SL, Lee SL et al (2017) Flavored e-cigarette liquids reduce proliferation and viability in the CALU3 airway epithelial cell line. Am J Physiol Lung Cell Mol Physiol 313(1):L52–L66. https://doi.org/10.1152/ajplung.00392.2016

    Article  PubMed  PubMed Central  Google Scholar 

  26. Lin VY, Fain MD, Jackson PL et al (2019) Vaporized E-Cigarette liquids induce ion transport dysfunction in airway epithelia. Am J Respir Cell Mol Biol 61(2):162–173. https://doi.org/10.1165/rcmb.2017-0432OC

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Gaurav R (2019) Vaping Away Epithelial Integrity. Am J Respir Cell Mol Biol 61(2):127–129. https://doi.org/10.1165/rcmb.2019-0016ED

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  28. Zengin MO, Cinar E, Kucukerdonmez C (2014) The effect of nicotine on choroidal thickness. Br J Ophthalmol 98(2):233–237. https://doi.org/10.1136/bjophthalmol-2013-304044

    Article  Google Scholar 

  29. Varghese SB, Reid JC, Hartmann EE, Keyser KT (2011) The effects of nicotine on the human electroretinogram. Invest Ophthalmol Vis Sci 52(13):9445–9451. https://doi.org/10.1167/iovs.11-7874

  30. Neal MJ, Cunningham JR, Matthews KL (2001) Activation of nicotinic receptors on GABAergic amacrine cells in the rabbit retina indirectly stimulates dopamine release. Vis Neurosci 18(1):55–64. https://doi.org/10.1017/s0952523801181058

    Article  CAS  PubMed  Google Scholar 

  31. Munteanu T, Noronha KJ, Leung AC, Pan S, Lucas JA, Schmidt TM (2018) Light-dependent pathways for dopaminergic amacrine cell development and function. Elife 7:e39866. https://doi.org/10.7554/eLife.39866

  32. Pereira CB, Strupp M, Eggert T, Straube A, Brandt T (2000) Nicotine-induced nystagmus: three-dimensional analysis and dependence on head position. Neurology 55(10):1563–1566. https://doi.org/10.1212/wnl.55.10.1563

    Article  CAS  PubMed  Google Scholar 

  33. Zingler VC, Denecke K, Jahn K et al (2007) The effect of nicotine on perceptual, ocular motor, postural, and vegetative functions at rest and in motion. J Neurol 254(12):1689–1697. https://doi.org/10.1007/s00415-007-0621-9

    Article  CAS  PubMed  Google Scholar 

  34. Roos YBWEM, Jongh De, Felix E, Crevits L (1993) The effect of smoking on ocular saccadic latency time. Neuro-Ophthalmol 13(2):75–79

    Article  Google Scholar 

  35. Paley GL, Echalier E, Eck TW et al (2016) Corneoscleral laceration and ocular burns caused by electronic cigarette explosions. Cornea 35(7):1015–1018. https://doi.org/10.1097/ICO.0000000000000881

    Article  PubMed  PubMed Central  Google Scholar 

  36. McCague Y (2018) Ocular chemical burns secondary to accidental administration of e-Cigarette liquid. Adv Emerg Nurs J 40(2):104–109. https://doi.org/10.1097/TME.0000000000000183

    Article  PubMed  Google Scholar 

  37. Jamison A, Lockington D (2016) Ocular chemical injury secondary to electronic cigarette liquid misuse. JAMA Ophthalmol 134(12):1443. https://doi.org/10.1001/jamaophthalmol.2016.3651

    Article  PubMed  Google Scholar 

  38. Shields CL, Kim M, Lally SE, Chévez-Barrios P, Shields JA (2020) Eye cancer in a young male with a vaping history. Indian J Ophthalmol 68(8):1699–1701. https://doi.org/10.4103/ijo.IJO_27_20

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Funding

This study was funded by an unrestricted grant from Research to Prevent Blindness (RPB), 360 Lexington Avenue, 22nd Floor New York, NY 10017. No support was received for the publication of this article.

Author information

Authors and Affiliations

  1. Department of Stem Cell and Regenerative Biology, Harvard University, 7 Divinity Avenue, Cambridge, MA, 02138, USA

    Tanisha Martheswaran

  2. Burrell College of Osteopathic Medicine, 3501 Arrowhead Dr, Las Cruces, NM, 88003, USA

    Margaret H. Shmunes

  3. Hoopes Vision Research Center, 11820 State Street Suite #200, Draper, UT, 84020, USA

    Yasmyne C. Ronquillo & Majid Moshirfar

  4. Department of Ophthalmology and Visual Sciences, John A. Moran Eye Center, University of Utah School of Medicine, 65 Mario Capecchi Drive, Salt Lake City, UT, 84132, USA

    Majid Moshirfar

  5. Utah Lions Eye Bank, 6056 Fashion Square Drive Suite 200, Murray, UT, 84107, USA

    Majid Moshirfar

Authors
  1. Tanisha Martheswaran
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Margaret H. Shmunes
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Yasmyne C. Ronquillo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Majid Moshirfar
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

All named authors meet the International Committee of Medical Journal Editors criteria for authorship for this manuscript, take responsibility for the integrity of the work, and have given final approval to the version to be published.

Corresponding author

Correspondence to Majid Moshirfar.

Ethics declarations

Conflict of interest

No authors have a conflict of interest related to this work.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and Permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Martheswaran, T., Shmunes, M.H., Ronquillo, Y.C. et al. The impact of vaping on ocular health: a literature review. Int Ophthalmol 41, 2925–2932 (2021). https://doi.org/10.1007/s10792-021-01842-w

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10792-021-01842-w

Keywords

search

Navigation