Podcast – Episode 3

Protect, Prevent, Preserve Your Eyes Podcast: EPISODE 3

Elizabeth Nystrom & Olivia Mohney



Elizabeth: Hi again, welcome back to Protect, Prevent, Preserve Your Eyes. Once again, my name is Elizabeth Nystrom, a Master of Public Health Student at Michigan State University, and this is Olivia Mohney, a public relations student at Baylor University.

Olivia: We will be your guides for this educational podcast which will look at various eye conditions, risk factors for developing these conditions, and what you can do to aid in preventing some of these conditions.

E: We both work for Association for the Blind and Visually Impaired (ABVI), a nonprofit organization focused on helping those with vision loss thrive in a sighted world. More background information on ABVI, the services offered, and ways to donate or get involved can be found on the website abvimichigan.org.

O: For today’s episode, we will be discussing how smoking and UV exposure separately affect eye health and we’ll have a little Q and A session with ABVI’s occupational therapist about low vision, devices, and aids. With that, let’s get started!



E: This episode of the podcast will be a little bit more technical because there is so much data and so many studies that demonstrate the negative affect that smoking has on our health and our eyes. These studies deserve to be listed by name, when applicable.

O: Smoking tobacco harms nearly every organ of the body, increases oxidative stress and creates inflammatory responses in our bodies, both of which have been shown to negatively affect our overall health and eye health. The CDC reports that nearly 1 in 5 deaths are related to cigarette smoking. Tobacco use increases the risk for heart disease, stroke, and lung cancer significantly.

E: In terms of eye health, smoking has been shown to increase intraocular pressure (IOP), which is a risk factor for developing glaucoma. More specifically, smoking is a significant risk factor for the development and progression of cataracts, AMD, and diabetic retinopathy.

O: There is a huge body of evidence that links tobacco use and AMD and cataract formation, yet the literature directly linking tobacco use to glaucoma is conflicted and most of it surrounds intraocular pressure, as previously mentioned. If you recall from our last episode, intraocular pressure is the pressure within the eye.

E: One study, the U.S Twin Study of Age-Related Macular Degeneration or AMD found evidence that tobacco use increases the risk of AMD. Particularly, participants in the study who currently smoked were 1.9 times more likely than never-smokers to have AMD. Additionally, individuals in the study who were former smokers also showed an increased risk for developing AMD.

O: Back in our first episode, we discussed the difference between wet and dry AMD, and we mentioned that the wet kind was also known as neovascular AMD. One other study, the Beaver Dam Eye Study found that current smokers were between 2.5 and 3.29 times more likely to develop neovascular AMD than never-smokers or former smokers.

E: One final study that looked at the relationship between smoking and AMD was the Blue Mountains Eye Study, which concluded that current smokers were 4.46 times more likely to develop late AMD, nearly 5 times more likely to develop atrophic AMD, and 3.26 times more likely to develop neovascular AMD than never-smokers.

O: In short, the evidence linking smoking and AMD is surmountable and hard to argue with. Let’s shift gears and look at other eye conditions.

E: In addition to their results that linked smoking and AMD, the Blue Mountains Eye Study and the Beaver Dam Eye study also found that current smokers were more likely than never-smokers to develop several forms of cataract and to require cataract surgery.

O: Regarding glaucoma: the Blue Mountains Eye Study found evidence that smoking increases intraocular pressure, which is a significant risk factor for glaucoma. But this study found no evidence that smoking directly increased the risk for glaucoma.

E: However, one other private study found that heavy smokers were 4 times more likely to develop primary open angle glaucoma than never-smokers.

O: To close out our section on smoking and eye health, we’d like to mention the reversibility of tobacco use. Many of you may be wondering, “I used to smoke but I quit, do I still have an increased risk for developing any of these eye conditions?”

E: To that, the answer is yes! In terms of lung health, after quitting smoking, your lungs begin to heal, and lung function slowly recovers. However, regarding our eyes, former smokers still have an increased risk of developing AMD as compared to never-smokers, however, this risk was lower than that of current smokers.

O: Additionally, an independent study which looked at a bunch of data from other studies found that there was a strong association between smoking and cataracts, such that even ex-smokers had a significantly higher risk than never-smokers for cataract development.

E: We know that this section may have been a bit technical and overwhelming, but the summation of findings concludes that just as smoking is bad for your overall health, it is likewise bad for your eye health.

O: Although quitting smoking can be difficult, we are here to provide a couple of tips to quit smoking for good. The hardest part about giving up smoking is obtaining the right mentality. Finding a motivational reason to quit smoking is half the battle. Putting yourself in the right headspace will allow you to find the initial courage to give up smoking. It is also important to lean on friends and family who can help you through the quitting process. Having a group of people who are healthy influences that can support you is important. There are also foods that can help you quit smoking! Visit our website to see the full list of foods that can help you quit smoking today!



UV Light

O: For this next segment, we’ll look at what UV light is, how we can be exposed to it, and how it affects our eye health. You have likely heard the terms UV light or ultraviolet light before; these are the same thing, and our main source of UV light exposure is the sun. Other sources of UV light include tanning beds. Blue light is light emitted from electronic devices and can likewise be harmful to the eye. Visible light is just light, for example, light from a light bulb or the color of an object.

O (continued): Exposure to sunlight and UV rays can have detrimental effects of multiple aspects of the body, including the eye. We most commonly hear about the importance of wearing sunscreen outdoors, but in this episode, we’ll learn about the importance of protective eyewear while outside.

E: UV exposure results in oxidative stress and damage to the eye, which can lead to increased risk for a multitude of eye conditions. Multiple studies have suggested that excessive exposure to visible light, blue light, and UV light has the potential to cause damage to photoreceptors, stem cells, and retinal pigment epithelium, all critical components of the eye. The stem cells in your eye help to repair and heal the eye after daily wear and tear. Therefore, if they get damaged by excessive oxidative stress, they can no longer serve to repair.

E (continued): The condition that is most strongly associated with excessive UV exposure is pterygium (TER IH GEE UM), which is a growth of tissue on the conjunctiva of the eye that typically grows towards the pupil. The conjunctiva is the white part of your eye. Several studies have concluded that pterygia occur more commonly among individuals who live in areas where UV exposure is the highest, for example, near the equator. Additionally, individuals who live at these latitudes during the first 5 years of their lives are 40 times more likely to develop pterygia than other.

O: The association between UV exposure, cataract, and AMD have also been examined, but are less conclusive. One study found that individuals over 65 years of age who lived in areas with a longer duration of sunlight suffered from higher incidences of cataracts than similar individuals who lived in areas with less sunlight.

E: Another study, which examined middle-aged fisherman in China found that the risk for developing cataracts was significantly higher among the men who spend five or more hours per day outdoors than among men who spent most of their time indoors.

O: There have also been several studies, including the Beaver Dam Eye Study mentioned previously, that have found a positive relationship between amount of UV exposure and risk for AMD. However, it is currently believed that damage to the retina is caused primarily by blue light rather than UV light or visible light.

E: So how can you protect your eyes from UV light? Wear UV blocking lenses while outdoors! Currently, many eyeglass manufacturers are including UV protection as part of clear lenses and of course, there is always sunglasses and transition lenses. Most importantly, never look directly at the sun or an open flame. Looking directly at either of these will burn your retina, destroying the rods and cones in your eye. These are critical components for vision. It can also create a small blind spot in your central vision, known as a scotoma.

O: Much like smoking, there is substantial evidence that UV exposure and blue light exposure are bad for our eyes. We must do everything we can to protect our vision while outside or exposed to sunlight. There are lots of fashionable blue light glasses as well as sunglasses that can protect against harmful blue light exposure and UV rays.


O: We will now shift into the Q and A portion of our podcast. For this segment, we will be talking with Christina Hedlich, an occupational therapist for ABVI. Chris, welcome to the Triple P podcast, we are so happy to have you for this episode. Would you care to introduce yourself and let us know a little bit about you?


E: Well! Welcome to the podcast! Can you elaborate a bit about why you became an occupational therapist and specifically, why did you specialize in low vision?

ANSWER & freestyle back and forth commenting on her answer.

O: Can you help clarify how low vision differs from regular vision in the sense of visual acuities, peripheral vision, etc.?


O: I feel like there are some misconceptions on the differences between low vision and legal blindness. What classifies someone as being legally blind?


E: Specifically, how do you assist individuals who are low vision or legally blind and how does this compare to what a certified vision rehab therapist might do?


E: So, you mentioned working with devices, what types of devices specifically help with low vision?


O: Can anyone get these devices? Or what process would someone with low vision take so that they can purchase one of these devices?


E: You also mentioned helping individuals in their homes. What sort of assistance do you provide in the home to aid those in adapting to vision loss and/or blindness?


O: What would your best bit of advice be to protect our eyes and our eye health?


E: Finally, what is your favorite or most rewarding part about working for ABVI or with the visually impaired?


O: Chris, thank you so much for joining us today on this second episode of our podcast. It has been a pleasure to have the opportunity to interview you and you have provided such valuable insight into how we classify low vision and how occupational therapists can aid.



O: And thank you all for joining us once more today and listening to our podcast. Next week, we’ll talk a bit about the less controllable genetic components to eye disease.

E: As with all of our episodes, the references from this episode will be uploaded to ABVI website should any of the studies interest you, I will admit though, they are quite technical in their reporting. Thanks so much for listening to the Triple P Podcast if you would like to connect with us in between podcasts make sure to follow us on Instagram and Facebook, @abvimichigan and make sure to join us next week, thanks for listening to the Prevent, Protect and Preserve Podcast.



Bose, B., Najwa, A. R., & Shenoy P, S. (2019). Oxidative Damages to Eye Stem Cells, in Response to, Bright and Ultraviolet Light, Their Associated Mechanisms, and Salvage Pathways. Molecular Biotechnology, 61(2), 145–152. https://doi.org/10.1007/s12033-018-0136-x

CDC. (2020, December 15). Health Effects of Cigarette Smoking. Centers for Disease Control and Prevention. https://www.cdc.gov/tobacco/data_statistics/fact_sheets/health_effects/effects_cig_smoking/index.htm

Cruickshanks, K. J., Klein, R., & Klein, B. E. (1993). Sunlight and age-related macular degeneration. The Beaver Dam Eye Study. Archives of ophthalmology (Chicago, Ill. : 1960), 111(4), 514–518. https://doi-org.proxy2.cl.msu.edu/10.1001/archopht.1993.01090040106042

Cumming, R. G., & Mitchell, P. (1997). Alcohol, smoking, and cataracts: the Blue Mountains Eye Study. Archives of ophthalmology (Chicago, Ill. : 1960), 115(10), 1296–1303. https://doi-org.proxy1.cl.msu.edu/10.1001/archopht.1997.01100160466015

Hiller, R., Giacometti, L., & Yuen, K. (1977). Sunlight and cataract: an epidemiologic investigation. American journal of epidemiology, 105(5), 450–459. https://doi-org.proxy2.cl.msu.edu/10.1093/oxfordjournals.aje.a112404

Jain, V., Jain, M., Abdull, M. M., & Bastawrous, A. (2017). The association between cigarette smoking and primary open-angle glaucoma: A systematic review. International Ophthalmology, 37(1), 291–301. https://doi.org/10.1007/s10792-016-0245-0

Kelly, S. P., Thornton, J., Edwards, R., Sahu, A., & Harrison, R. (2005). Smoking and cataract: Review of causal association. Journal of Cataract and Refractive Surgery, 31(12), 2395–2404. https://doi.org/10.1016/j.jcrs.2005.06.039

Klein, R., Klein, B. E., Linton, K. L., & DeMets, D. L. (1993a). The Beaver Dam Eye Study: the relation of age-related maculopathy to smoking. American journal of epidemiology, 137(2), 190–200. https://doi-org.proxy1.cl.msu.edu/10.1093/oxfordjournals.aje.a116659

Klein, B. E., Klein, R., Linton, K. L., & Franke, T. (1993b). Cigarette smoking and lens opacities: the Beaver Dam Eye Study. American journal of preventive medicine, 9(1), 27–30.

Law, S. M., Lu, X., Yu, F., Tseng, V., Law, S. K., & Coleman, A. L. (2018). Cigarette smoking and glaucoma in the United States population. Eye, 32(4), 716–725. https://doi.org/10.1038/eye.2017.292

Lee, A. J., Rochtchina, E., Wang, J. J., Healey, P. R., & Mitchell, P. (2003). Does smoking affect intraocular pressure? Findings from the Blue Mountains Eye Study. Journal of glaucoma, 12(3), 209–212. https://doi-org.proxy1.cl.msu.edu/10.1097/00061198-200306000-00005

Mackenzie, F. D., Hirst, L. W., Battistutta, D., & Green, A. (1992). Risk analysis in the development of pterygia. Ophthalmology, 99(7), 1056–1061. https://doi-org.proxy2.cl.msu.edu/10.1016/s0161-6420(92)31850-0

Mitchell, P., Wang, J. J., Smith, W., & Leeder, S. R. (2002). Smoking and the 5-year incidence of age-related maculopathy: the Blue Mountains Eye Study. Archives of ophthalmology (Chicago, Ill. : 1960), 120(10), 1357–1363. https://doi-org.proxy1.cl.msu.edu/10.1001/archopht.120.10.1357

Moran, D. J., & Hollows, F. C. (1984). Pterygium and ultraviolet radiation: a positive correlation. The British journal of ophthalmology, 68(5), 343–346. https://doi-org.proxy2.cl.msu.edu/10.1136/bjo.68.5.343

Renard, J. P., Rouland, J. F., Bron, A., Sellem, E., Nordmann, J. P., Baudouin, C., Denis, P., Villain, M., Chaine, G., Colin, J., de Pouvourville, G., Pinchinat, S., Moore, N., Estephan, M., & Delcourt, C. (2013). Nutritional, lifestyle and environmental factors in ocular hypertension and primary open-angle glaucoma: an exploratory case-control study. Acta ophthalmologica, 91(6), 505–513. https://doi-org.proxy1.cl.msu.edu/10.1111/j.1755-3768.2011.02356.x

Roduit, R., & Schorderet, D. F. (2008). MAP kinase pathways in UV-induced apoptosis of retinal pigment epithelium ARPE19 cells. Apoptosis : an international journal on programmed cell death, 13(3), 343–353. https://doi-org.proxy2.cl.msu.edu/10.1007/s10495-008-0179-8

Seddon, J. M., George, S., & Rosner, B. (2006). Cigarette smoking, fish consumption, omega-3 fatty acid intake, and associations with age-related macular degeneration: the US Twin Study of Age-Related Macular Degeneration. Archives of ophthalmology (Chicago, Ill. : 1960), 124(7), 995–1001. https://doi.org/10.1001/archopht.124.7.995

Smith, W., Mitchell, P., & Leeder, S. R. (1996). Smoking and age-related maculopathy. The Blue Mountains Eye Study. Archives of ophthalmology (Chicago, Ill. : 1960), 114(12), 1518–1523. https://doi-org.proxy1.cl.msu.edu/10.1001/archopht.1996.01100140716016

Thornton, J., Edwards, R., Mitchell, P., Harrison, R. A., Buchan, I., & Kelly, S. P. (2005). Smoking and age-related macular degeneration: A review of association. Eye, 19(9), 935–944. https://doi.org/10.1038/sj.eye.6701978

Wong, L., Ho, S. C., Coggon, D., Cruddas, A. M., Hwang, C. H., Ho, C. P., Robertshaw, A. M., & MacDonald, D. M. (1993). Sunlight exposure, antioxidant status, and cataract in Hong Kong fishermen. Journal of epidemiology and community health, 47(1), 46–49. https://doi-org.proxy2.cl.msu.edu/10.1136/jech.47.1.46

Yam, J. C. S., & Kwok, A. K. H. (2014). Ultraviolet light and ocular diseases. International Ophthalmology, 34(2), 383–400. https://doi.org/10.1007/s10792-013-9791-x