It is no secret that alcohol in excess can cause serious problems.   The harmful effects of alcohol as a toxin in the brain and liver are well known.  In fact, alcohol can damage the heart as well and virtually every other bodily tissue in a high enough concentration and with prolonged exposure.

Other effects to the eye and vision from excessive alcohol use are less recognized.

The Centers for Disease Control and Prevention (CDC) defines excessive drinking as four or more drinks in one sitting for women and five or more drinks for men, or a weekly total of eight or more drinks for women and 15 or more drinks for men.

Some of the untoward effects of excess alcohol injestion is associated with poor nutrition when calories from alcohol replace nutritious food.  Vitamin A deficiency is associated with a dry cornea, keratinization of the cornea (a skin forming on the surface), corneal scarring and corneal perforation.

Although rare in the USA, severe vitamin A deficiency can cause night blindness.

Vitamin B1 or thiamine deficiency can result in double vision, eye muscle paralysis and nystagmus.

Acute effects of alcohol result in confusion, change in mental status and unsteady gait, depressed consciousness, nausea and vomiting and even death.

Deficiency in Vitamin B12 can damage the optic nerve which transmits vision from the eye to the brain.

The symptoms of sick optic nerve include impaired color vision and permanent visual loss.

There is a condition called tobacco – alcohol amblyopia which leads to a loss of central vision.

Heavy drinking may be associated with increased risk of cataract formation.   Age-related macular degeneration may get worse because of oxidative and toxic effects of alcohol on the retina.

Alcohol is a diuretic leading to dehydration.  Drinking alcohol contributes to dry eyes.

Ethanol in alcoholic beverages can be detected in the tear film, which makes the eyes feel dry and scratchy.

In addition, alcohol is a diuretic which may decrease tear secretion. Women seem to be more susceptible to the dry eye effects of alcohol.

Most alcohol-related eye and visual damages resolve with cessation of drinking.  Several dry eye related conditions result in permanent scarring.

Vitamin A supplement can reverse dry cornea and night blindness but not visual loss from scarring or perforation.

Any person with symptoms of sick optic nerve should have blood test for vitamin levels. Vitamin supplements and nutritional consult help to recover some visual loss.

In summary, chronic excessive alcohol consumption can cause severe eye damage.

Early detection, frank discussion and early treatment can reverse or minimize the visual loss.

Risks of Long-Term Excessive Drinking

Long-term excessive drinking can permanently damage your eyesight and can even lead to blindness in some cases.

1. Brain to Eye Communication

Excessive drinking can affect the eyes directly with alcohol found in the tear film.   The most profound effect, as a neurotoxin, is on the brain. As images from the eye are processed by the brain, if the brain is affected, vision will suffer.

With excess alcohol consumption, too much,  brain communication suffers.  Individuals will expreience lack of coordination, falls, blurred vision, double vision and even nystagmus.

 

2. Optic Nerve Damage

The optic nerve is made up of axons (nerve fibers), these axons can become damaged by alcohol, just like in the brain resulting in loss of central vision and blind spots.

The optic nerve sends electrical signals from the retina to the brain. A damaged optic nerve can lead to low vision and sometimes blindness. “Drinking yourself blind” is more than an expression, it can be reality.

To kill nerves causing pain around the eye, doctors actually inject ALCOHOL behind the eye to kill the nerves.

3. Toxic Amblyopia

Optic nerve damage brought on by alcohol will sometimes lead to a condition called toxic amblyopia or tobacco alcholol amblyopia. Although the eye may be normal in appearance, the function is lost and the vision declines and a central blind spot is clasic.  This disease is usually seen in alcoholics due to too much methanol consumption.  Isopropyl alcohol also can cause blindness due to the toxic effects of the alcohol.

Toxic amblyopia was very common before World War II due to excessive drinking and tobacco use. Now the disease has become rarer and is often only seen in people suffering from alcoholism.

The disease, after long-term substance abuse, will result in vision loss. There is no treatment available for the disease, only methods of coping with your new vision. Low vision aids may help for those with toxic amblyopia.

The disease can take anywhere between a few days to years to fully develop. Unfortunately, once it does start to progress, there isn’t much that can be done to stop it.

The main symptom is blind spots in your vision that gradually get bigger. Eventually, they will lead to legal blindness that cannot be reversed.

4. Rapid Eye Movements

Rapid eye movements are not unusual. In fact, we experience rapid eye movements at night during our REM cycle of sleep. Rapid eye movements while awake, however, are a rare and unusual occurrence.

Rapid eye movements or involuntary eye movements are often called nystagmus and can affect one or both eyes. These involuntary eye movements can cause your eyes to jump side to side.

Nystagmus may sometimes cause you to lose balance often or have trouble balancing yourself while standing for long periods of time.

Nystagmus is a sign of serious congenital or aquired damage to the sensitive oculomotor system.  Patients will need detailed evaluation by an Ophthalmologist, Neuroophthalmologist or Neurologist with neuroimaging such as a CT scan or an MRI  scan of the brain.

The problem generally cannot be fixed but sometimes there is a null point.  A null point is a direction that the movements are minimized.  The eye muscles can be moved to highlight this null point.   Also Botox (R) may be beneficial to blunt the movements.

5. Double Vision

Double vision is the most common vision problem associated with excessive drinking.  This problem is caused by a lack of coordination of the movement of your eyes resulting in each eye pointing in different directions.

Walking, operating machines, and driving will be difficult or impossible and possibly illegal.

 

6. Red Eyes

Bloodshot eyes, or red eyes, can indicate many things; allergies, dryness, inflammation, overuse, infections or lack of sleep. It is also a common side effect of too much drinking.   The irritation from the alcohol in the tear film contributes to irritation and redness.

7. Sensitivity to Light

Sensitivity to light or photophobia is a common side effect of a hangover. This vision problem can also affect inebriated people however they may have had too much to drink to remember.

Because your reaction time is slowed when you drink, so are your eyes. The pupils are slower to dilate and contract. So, if you go from a dark room to a light room or vice versa, you’d have a lot of trouble adjusting to the new lighting.

Alcohol is OK in moderation.  Set limits and respect your eyes and your body, you only have one set of eyes and one body.