Background: Smoking remains a major preventable threat to global public health. While its cardiovascular, respiratory, and oncological effects are well established, its ocular impact receives less attention in clinical and public health settings.

Aim: To examine the effects of smoking on ocular structures, visual function, and developmental visual outcomes, and to explore the implications for nursing practice and public health.

Methods: A systematic review was conducted in accordance with PRISMA 2020 guidelines. Due to heterogeneity in study designs and outcome measures, findings were synthesized narratively. Epidemiological, clinical, and meta-analytic studies examining the association between smoking and ocular outcomes were systematically identified, screened, and synthesized according to predefined eligibility criteria.

Results: Smoking was consistently associated with age-related macular degeneration, cataract, dry eye disease, inflammatory disorders, retinal vascular disease, and visual impairment. Prenatal exposure was linked to developmental visual abnormalities. Proposed mechanisms include oxidative stress, vascular dysfunction, and inflammation.

Implications for Nursing: Understanding smoking-related ocular risks can support nurses in integrating vision-health education into smoking cessation counseling and preventive care strategies.

Conclusion: Smoking is a modifiable risk factor for vision-threatening conditions, and strengthened cessation strategies and interdisciplinary care may reduce preventable visual impairment.