It is very unlikely that alcohol in moderation causes any problems to your eyes, however, the opposite can be said for consumption in excess. High levels of alcohol consumption can have short-term and long-term effects on the eye, and consuming too much of the wrong kind of alcohol, in some cases, can cause blindness. Ophthalmologist Payal Patel, MD, stated how our diet affects our body, and a poor diet with heavy alcohol does result in higher toxin levels and reduced vitamin absorption, which in turn affects the health of your eyes (Patel, 2019). Alcohol in large amounts can be very detrimental and it is important to remain aware of the risks so that this condition can be prevented, or treated when detected at an earlier stage.
Alcohol in any amount can have both negative physical and psychological impacts on your health. Amongst one of the short-term impacts specific to the eyes is double vision. Double vision occurs when two different images are seen by both eyes and both of these images are sent to the brain and the brain combines these images to be seen as double. (Bedinghaus, 2020). In normal binocular vision, both eyes view the same image of interest, the fovea of these eyes send the information to the same neurons in the visual cortex, simulating the same cortical area and are seen as being in the identical visual direction. These images are combined at the visual cortex to form a 3D image. In diplopia, the object you want to look at falls onto different points on the retina. This results in different cortical neurons being simulated and you see the single object in two different directions, hence the double vision. Blood alcohol concentration (BAC) is the percentage of alcohol present in the bloodstream of an individual. When an individual has a BAC of 0.01%, their blood supply has one part of alcohol for every 1000 parts of blood. When the BAC reaches 0.15-0.19% blurred or double vision will be seen (Monico,2020). Eye movements are controlled by the 6 ocular muscles in each eye and must be well coordinated in order for the eyes to work together and 3 cranial nerves supply these extraocular muscles bringing the input from the brain to the eyes. A research study that was conducted found that Alcohol is also known to work as a depressor to the central nervous system. If alcohol is affecting the central nervous system and creating a defect in these pathways, there will be a direct effect on the extraocular muscles, leading to alterations in eye movements. The study also found that the activity of the inhibitory neurotransmitter GABA may be decreased when alcohol is consumed. GABA can be found in the brain, including in the visual cortex. It is involved in visual function processing, including ocular movement regulation. The study concluded that alcohol does affect vision and influences eye movements, leading to double vision (Silva, 2017). Double vision can make life very difficult, specifically in completing simple tasks (Bedinghaus, 2020).
Another effect of Increased alcohol consumption is that it leads to decreased contrast sensitivity and physiological changes to the eye. The world health organization states that alcohol is one of the main causes of accidents on the road. The reason for this is that alcohol deteriorates vision so daily activities which require perfect vision like driving, are directly affected (Castro,2014). A study conducted by Castro evaluating the influence of alcohol on retinal-image quality and visual performance under low-illumination conditions found that the higher the rate of alcohol consumption, the poorer the visual discrimination capacity. In surroundings of high luminance, there was also a reduction in visual discrimination, accompanied by an increase in saccades and a deterioration in contrast sensitivity (Castro,2014). Contrast sensitivity is the ability to make distinctions between different objects depending on darkness or brightness (Rosenthal,2007). This is altered by alcohol consumption. As alcohol reduces the ability of the aye to adjust its vision for brightness and contrast, it is extremely dangerous for driving. A decrease in contrast sensitivity can lead to a loss of spatial awareness and mobility and increase the risk of accidents. Alongside driving at night, reduced contrast sensitivity can also make it difficult to recognize faces, read instructions or navigate (Rosenthal, 2007). When large amounts of alcohol are consumed, pupil size increases. The larger the pupil size, the poorer the retinal-image quality because the light penetrates the greater ocular medium, increasing aberration of the eye and scattering. Leading to a poorer image. This alongside the decreased contrast sensitivity, leads to poorer vision. Though this may be a short-term effect, if a drinking problem is not dealt with, this person may be a threat to themselves and other on the road. Alcohol will be affecting their decision-making ability, as well as how safely they are able to drive on the road(Castro, 2019). These physiological changes and visual alterations can make daily life very difficult, hence why excess consumption should be avoided.
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Alcoholics tend to have poor vision due to vitamin deficiency. Vitamin absorption in the liver is affected by heavy drinking. Vitamins, specifically Vitamin B-1 and Vitamin A are required to maintain healthy eyesight. A lack of Vitamin B-1 can lead to the weakness of the eye muscles with a deficiency in Vitamin A leading to night blindness, thinning of the cornea, corneal perforation, and dry eyes. In some cases, the damage to the retina could be so severe that it leads to blindness (CooperVision). The more long-term damage that can be caused due to excessive drinking is tobacco-alcohol amblyopia. This is a condition where vision is lost bilaterally. Patients who suffer from tobacco-alcohol amblyopia often complain about how their vision is blurred and how they are unable to read small texts, or differentiate between red and green (Prakash). Alcoholic amblyopia is also often referred to as optic neuropathy, however, the main damage is not in the optic nerve, rather it is localized to the retina, chiasm or optic tracts (Behbehani). Even though the condition has been linked to alcohol, it has been found that the condition is very strongly linked to nutrition and it is the diet and lack of vitamins that often causes it. A case was reported regarding a 33-year-old male who was struggling with alcohol addiction and was drinking large amounts daily. This male then also gave up food for a duration of 7 days when he was struggling with abstinence of alcohol. He later developed blurry vision and the inability to distinguish between color and depth, showing signs of optic neuropathy. His symptoms were reversed with a proper diet, vitamin supplements and by staying away from alcohol. (Prakash). Although the toxicity of alcohol can lead to lesions in these regions in the eye, a poor diet with a lack of nutrients, specifically Vitamin A and Vitamin B-1, are seen as the main cause of the condition. Alcohol is what stops these vitamins from being absorbed so it is very important that people are aware of the harm excessive drinking can bring to the body, in particular the eyes. Those who are struggling with addiction can be given psychotherapy with the aim of helping them achieve abstinence and prevent a relapse. Similar psychotherapy was offered to the 33-year-old male who was also given anti-craving agents(Prakash). A Clinician can also play a role in detecting this condition before the bilateral loss of vision occurs as it can be treated with the correct interventions(Prakash).
Alcohol also has many other short term effects and can cause other specific long-term damage to the eye. Eye twitching and dry eyes are just two of many other short term effects that alcohol can have on the eye (CooperVision). Although these short-term effects reduce with time, they are uncomfortable and can be quite frustrating to endure. Long-term damage includes the increased risk of cataract formation (CooperVision). Cataracts are cloudy regions in the eye that interfere with vision. Multiple studies have found that the risk of cataract formation is significantly greater in people who consume alcohol regularly as opposed to those who don`t (AOA). The risk of age-related macular degeneration, a condition that affects the middle part of your vision (NHS), is also increased with excessive alcohol consumption. The risk of both cataracts and age-related macular degeneration can be reduced through the consumption of more vitamins, such as Vitamin C, Vitamin E and zinc. Alcohol, however, as mentioned earlier, minimizes the absorption of these vitamins in the liver, hence increasing the risk of such conditions (AOA).
Even though all of the mentioned health conditions can occur due to alcohol consumption, this often occurs when someone is a heavy drinker or when alcohol is consumed in excess. Many who regularly drink don`t face these conditions, however, it is stressed not to consume a lot because of the risks attached to it. Encourage regular drinkers to visit optometrists regularly for health check-ups so that any complication may be detected in its early stage.
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