UCL Institute of Ophthalmology


Smoke Gets in Your Eyes: The Institute in History

15 September 2015

King James the First of England is famous for his hatred of tobacco smoke and he was the first person to tax the weed. When it came to smokers in Russia the Tsar had first offenders whipped and second offenders hung. He didn’t like snuff-takers either: they had their noses cut off. At one time some women believed that smoking a pipe would prevent their husbands from committing adultery and monks advised people to smoke to help them become more chaste.

In 1959 (the same decade that Richard Doll established the link between cigarette smoke and lung cancer) James H. Doggart of the Institute of Ophthalmology, who was also a consultant at the Moorfields and Great Ormond Street Hospitals, wrote an article entitled "Smoking as a factor in visual disturbance" in which he equates the effects of nicotine with those of curare, famous for killing you instantly when fired at you on the tip of a South American arrow. Doggart writes that the only known carcinogenic substance in tobacco in his time was arsenic.

In the sixteenth century tobacco leaves were used as a remedy for cancer and as a prophylactic against the plague. Schoolboys at Eton were taught how to smoke to ward it off and one who refused to learn was flogged. Jean Nicot, the French Ambassador to Lisbon from 1559 to 1561, also recommended tobacco leaves for their medicinal properties and it is from his name that we get the word nicotine.

Doggart tells us that, in Australia in 1897, some horses went blind after eating a local variety of the tobacco plant (Nicotiana suaveolens). Eye problems happen to nicotine addicted humans too:  according to Doggart conjunctivitis is common among smokers and so too is toxic amblyopia, a disorder of the optic nerve caused by tobacco. One of his patients developed a recurrent corneal abrasion after jabbing his eye with the lighted end of a cigarette when the other end of it had stuck to his lips but that was just bad luck (or plain idiocy!). Another smoker coughed so hard that he managed to detach his retina.  Nicotine also causes thromboangiitis obliterans for which there is no known cure (google it).

Doggart’s articles are collected together with those of many other luminaries of the Institute as part of the Ophthalmology Historical Collection in The Joint Library of Ophthalmology, Moorfields Eye Hospital & UCL Institute of Ophthalmology.