A commentary notes that although a difference of 5 to 6 μm in average circumpapillary retinal nerve fiber layer (RNFL) thickness is unlikely to translate into a detectable difference in visual function in children aged 12 to 13 years, the risk of subsequent development of visual impairment should not be overlooked. It adds that whether thinner RNFL in the children of mothers who smoked during pregnancy will increase the risk of developing optic neuropathies and neurodegenerative disorders is an important question for future studies