DEAR DR. DONOHUE: Everything I read or hear about macular degeneration is always about dry macular degeneration. I happen to have the wet kind, and would like to know what its treatments are. I’ve heard that vitamins work. Do they? Thank you. – T.R.

In the well-off countries of the world, macular degeneration is the leading cause of blindness in people over 50. There are two varieties, wet and dry. The dry kind is the more common of the two, accounting for 85 percent to 90 percent of all macular degeneration cases. Both involve deterioration of the macula, a small circle on the retina, jam-packed with vision cells necessary for high-resolution sight like reading, watching TV, distinguishing faces and driving. Wet macular degeneration comes from a sudden proliferation of fragile blood vessels blossoming in and around the macula. Those vessels leak fluid and blood, and disrupt that sensitive area of sight.

Wet macular degeneration often comes on quickly and can progress rapidly.

You might have heard of the vitamin-mineral mixture used for slowing the progression of macular degeneration. It consists of vitamins C and E, beta-carotene and the minerals zinc and copper. It is much more useful for dry macular degeneration. For wet macular degeneration, eye doctors can inject the eye with medicines that stop the generation and growth of new, delicate blood vessels. Lucentis and Avastin are two examples. Photodynamic therapy is another method of handling wet degeneration. Here, a drug that is sensitive to light is injected into a blood vessel. The drug localizes in the newly formed, fragile, troublemaking macular vessels. A laser is flashed on those vessels and they dry up.

I don’t know if your doctor has suggested any treatment. It may be that you’re not at a stage when therapy would provide the most benefit.

DEAR DR. DONOHUE: I need your advice. I had a mastectomy in 1981, and it was followed with chemotherapy and radiation. Three years ago, I had ovarian cancer. I also have osteoporosis, and I recently fractured a foot bone that has not yet healed. A nutritionist advised I take vitamin D and vitamin K. I don’t know why I need vitamin K. Do I? – S.F.

For years, vitamin K’s principal action was believed to be only in its involvement with blood clotting. In the past few years, researchers have learned that vitamin K plays an important part in maintaining bone health.

Vitamin K comes in two forms: one called menaquinone-4 and the other, phylloquinone. The menaquinone-4 type is the one that does the most for bones.

With your history, vitamin K would be a great benefit.

DEAR DR. DONOHUE: In my 58 years, I never have had any problem with my scalp. My hair has turned a salt-and-pepper color. Due to vanity, I have been coloring it for the past several years. I have never experienced any problems. Recently I have had a rash of pimples forming on my scalp at the hair shaft. They hurt when the scalp is touched or the hair brushed. I had a good friend look at my scalp with a magnifying glass, and he says they look like small pimples. He removed a hair with tweezers and a small discharge came out of the pimple. I am considering letting my hair grow back to its natural color to see if the dye has anything to do with this. Any suggestions? – N.N.

I like your approach. The dye might be irritating your scalp, and the hair follicles might have become infected secondary to the irritation. If things don’t clear up after going dyeless for a couple of months, have a doctor take a look. You might need an antibiotic prescription.

DEAR DR. DONOHUE: I lost vision in my left eye years ago due to a brain tumor. Now I see flashing colors off to one side in my right eye. The eye doctor said it is caused by an aura. Please explain what an aura is. I can’t find it in any of my books. – P.K.

In medicine, an aura (OR-uh) is a warning sign.

The condition where an aura is most often found is migraine headache. About 15 percent of people who get such headaches experience a warning that the headache is about to occur. They see a C-shaped jagged line off to one side of their vision, and often, it is multicolored and flashing. It lasts anywhere from 20 to 25 minutes, and then the headache strikes.

A few people have the aura without getting the headache. Then the aura is called a migraine equivalent.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475.

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