Smokers are up to four times more likely to go blind in old age, according to research.

A study in the British Medical Journal says cigarettes increase the chances of developing age-related macular degeneration. Cigarette packets already carry severe health warnings about the dangers of smoking. The researchers, from the University of Manchester, say the risk of going blind should be added to the list. Age-related macular degeneration (AMD) is the leading cause of adult blindness in the UK, affecting about 500,000 people. It results in severe and irreversible loss of central vision, especially in people over the age of 60. Ophthalmic surgeon Simon Kelly and his team claim around 54,000 people in the UK have AMD as a direct result of smoking. Of these, they said 17,800 are completely blind. The researchers are calling for a sustained public health campaign to raise awareness of the link between smoking and blindness, as well as more commonly known risks such as cancer. Mr Kelly said: "Evidence indicates that more than a quarter of all cases of AMD with blindness or visual impairment are attributable to current or past exposure to smoking. "Patients, health professionals, and the public will benefit from greater awareness of this causal association." Greater publicity Researchers said evidence suggests that giving up smoking helps reduce the risk of AMD in later life. Quitting can also affect the long-term response to treatments such as laser therapy. The Royal National Institute for the Blind (RNIB) agrees that greater publicity is needed to highlight the link between smoking and eye damage. "People fear losing their sight more than any other sense, said Anita Lightstone, RNIB Head of Eye Health. "Therefore the fact that smoking does significantly increase a person's chances of losing sight from AMD should be more widely publicised. "Awareness needs to be raised and an eye health warning included on all cigarette packets, to help lower the number of people losing their sight from AMD." The pro-smoking organisation Forest has reacted angrily to the research branding it as "scaremongering". Forest director Simon Clark said: "These health scares are getting out of hand. "I think people have to ask how many people do they know who have gone blind through smoking. "We have health scares on a daily basis and I think it is counter productive. "We are getting to the stage where people are so cynical that not only won't they listen but they will start to laugh at scientists and the medical establishment, which could have serious consequences in the future." Treatment delay Smoking causes lung cancer, but is also associated with more than 50 different diseases and disorders - many fatal. Around 13 million Britons smoke and half of all smokers will die prematurely. There are 120,000 smoking-related deaths each year and smoking-related diseases cost the NHS £1.5bn annually. The government is currently under pressure for delaying the implementation of guidelines from the National Institute of Clinical Excellence, which say that a treatment known as photodynamic therapy should be made available to treat AMD. Ministers say the NHS needs more time to train up specialists, but the RNIB argues that the NHS already has the capacity to offer the treatment, and says the delay will result in some people going blind unnecessarily.

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