Smokers are up to four times as likely to become blind in later life from age related macular degeneration (AMD) than non-smokers, but many remain largely unaware of this risk, warn researchers in this week's BMJ.

AMD is the most common cause of adult blindness, which results in severe irreversible loss of central vision.

One in five cases of AMD in the UK may be attributable to smoking. This represents around 54,000 people over 69 years of whom nearly 18,000 are blind.

Evidence also shows that quitting smoking slows the development of age related macular degeneration, whereas continued smoking can affect the long term response to treatments such as laser therapy.

A sustained public health campaign in the UK is warranted to raise awareness of the link between smoking and blindness, say the authors. This should include offering smoking cessation support to people attending eye clinics and more novel, varied, and specific pack warnings of the impact of smoking on eyesight.