Effects of Nutrition, Alcohol, and Smoking
Although nutritional deficiencies have been demonstrated to cause cataracts in animal models, this etiology has been difficult to confirm in humans. Initial population-based studies have found that increased prevalence of age-related cataracts has been associated with lower socioeconomic status, lower education level, and poorer overall nutrition. Severe episodes of dehydration caused by diarrhea may be linked to an increased risk of cataract formation. More recent studies of supplementation with vitamins, antioxidants, and estrogen have not consistently correlated these supplements with a decreased risk for cataract development.
High-dose vitamin use may pose risks. Tobacco smokers taking high doses of beta carotene appear to have an increased risk of lung cancer, death from lung cancer, and death from cardiovascular disease. In addition, women taking supplemental doses of vitamin A have an increased risk of hip fracture.
Tobacco smoking, the use of smokeless tobacco products, and excessive alcohol consumption are significant, avoidable risk factors for cataract. In numerous studies performed worldwide, these practices have consistently been associated with an increase in the frequency of nuclear opacities. Although patients may know the general health risks of smoking and excessive alcohol consumption, they may not know about the associated increased risks of ocular conditions, including macular degeneration and cataract. Ophthalmologists can inform their patients about these risks, and they are in a strong position to encourage individuals to stop smoking and reduce alcohol consumption.
Kanthan GL, Mitchell P, Burlutsky G, Wang JJ. Alcohol consumption and the long-term incidence of cataract and cataract surgery: the Blue Mountains Eye Study. Am J Ophthalmol. 2010; 150(3):434–440.
Raju P, George R, Ve Ramesh S, Arvind H, Baskaran M, Vijaya L. Influence of tobacco use on cataract development. Br J Ophthalmol. 2006;90(11):1374–1377.
Sella R, Afshari NA. Nutritional effect on age-related cataract formation and progression. Curr Opin Ophthalmol. 2019;30(1):63–69.
Excerpted from BCSC 2020-2021 series: Section 11 - Lens and Cataract. For more information and to purchase the entire series, please visit https://www.aao.org/bcsc.