The effects of tobacco waterpipe smoking on the ocular surface

ABSTRACT

Clinical relevance

This study was conducted to determine the effect of tobacco waterpipe smoking on the ocular surface. The findings could be useful in understanding ocular surface changes and associated symptoms in waterpipe smokers.

Background

Tobacco smoking has been reported to have many systemic and ocular adverse effects. However, the effect of specific delivery methods of tobacco using a waterpipe on the eye has not been commonly studied.

Methods

This study enrolled 33 waterpipe smokers (with no history of cigarette smoking) and 31 non-smokers of age-matched control group. Participants were tested in the following sequence: the presence of ocular symptoms using Ocular Surface Disease Index questionnaire, tear osmolarity, tear film break-up time and corneal staining. Statistical analysis using unpaired sample t-tests was performed to study the difference in ocular surface parameters obtained for each group. The prevalence of dry eye disease was also measured in each group.

Results

The mean tear osmolarity values and corneal staining were significantly higher (P < 0.05) in the waterpipe smoking group (314.64 ± 15.24 mOsm/L and 0.73 ± 0.94, respectively) compared to non-smokers (306.42 ± 13.48 mOsm/L and 0.10 ± 0.30, respectively). The mean values obtained from tear film break-up time test were significantly lower (P < 0.05) in the waterpipe smoking group (5.82 ± 3.77 s) compared to non-smokers (8.32 ± 3.46 s). The difference in the average Ocular Surface Disease Index scores in the study groups was not statistically significant (P > 0.05). The prevalence of dry eye disease was significantly higher (p < 0.05) in the waterpipe smoking group (57.6%), compared to the control group (35.5%).

Conclusion

Waterpipe smoking could have a significant effect on tear film parameters and be associated with dry eye disease. Dryness also seems to be more prevalent among waterpipe smokers.

KEYWORDS:

• Dry eye
• ocular surface
• waterpipe tobacco smoking

Acknowledgements

This study was approved and sponsored by the Deanship of Research at Jordan University of Science and Technology. The authors would like to thank all participants who participated in this study.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Jordan University of Science and Technology – Deanship of Research [20160018].