Yafoo writes

Smoke gets in your eyes
I expect the following is a familiar scenario to many readers, though I want to relate it nonetheless to see if anyone has had a different, more positive outcome. After I had completed some latest CET - on macular degeneration - a female patient came in for her regular appointment. She impressed me by leading the conversation which mainly featured her health, and how she had been recommended to take vitamin supplements to ward off ocular diseases, as well as other items prescribed by her doctor.

However, on leaning down to carry out the ophthalmoscopy it was impossible not to notice the stale smell of cigarette smoke. Later I broached the subject as tactfully as I thought I could.

'You do realise that smoking is making any benefits the vitamins you are taking disappear?' I asked.

She admitted that she really should stop smoking but it came across as the usual embarrassed mantra many smokers express before going off to open another packet.

I'm always trying to educate my patients, I think that's part of my job. Admittedly, discussing lifestyle choices is a difficult topic - and for us non-smokers it's hard not to sound holier than thou when discussing it with people who have had the habit for decades. But unless my patient's unconvincing pledge to end her hobby is turned into action she'll continue to risk developing a serious ocular condition, regardless of her purchase and use of vitamins.

The proof of smoking's harm is well documented. Only this week a new study has revealed that smoking doubles the risk of eye disorder for older people. Given this publicity it frustrates me when you know the person sitting before you in the testing chair is rightly concerned about their eye health, but complacent about their unhealthy lifestyle.

Aside from the research it does seem illogical that a patient can be prescribed items from NHS resources which are rendered less effective by the individual's lifestyle. While patients such as mine continue to help themselves to 'free at the point of access' resources, Department of Health anti-smoking campaigns are necessary to help them help themselves, and give up.