DEAR DR. DONOHUE: When I turned 60, my doctor insisted that I see an eye doctor. Much to my surprise, the eye doctor found that I had lost a good deal of side vision and that my eye pressure was high. He told me I had glaucoma and that I needed immediate treatment. I’m familiar with glaucoma through word of mouth, but I would like some information on it. What’s eye pressure? – K.M.

ANSWER:
The eye’s front chamber is filled with fluid that’s being constantly made and constantly drained. A disruption in the drainage of that fluid out of the eye raises pressure in the eye. (This pressure has nothing to do with blood pressure.) Elevated eye pressure squeezes the optic nerve at the back of the eye. That nerve brings images to the brain, where we visualize the world. If pressure isn’t relieved, blindness results. The first sign of trouble is loss of side vision.

It is possible to have glaucoma with normal eye pressure. Inspection of the optic nerve is the essential part of glaucoma detection. Changes in the appearance of the optic nerve can occur even at normal pressures. In those instances, lowering the pressure, even though it’s normal, preserves vision.

Everyone needs an eye exam that includes measuring the fluid pressure in the eye along with inspection of the optic nerve. People in their 40s should have such an exam every two to four years, and people in their 60s need one yearly or every other year.

Eyedrops often can reduce eye pressure. Oral medicines also bring it down. If neither does so, then opening the eye’s drainage channel with a laser or through surgery saves the optic nerve.

TO READERS: Answers to questions on edema and lymphedema can be found in the booklet on that topic. Readers can obtain a copy by writing: Dr. Donohue – No. 106, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.75 U.S./$6 Can. with the recipient’s printed name and address. Please allow four weeks for delivery.

DEAR DR. DONOHUE: I have fought with athlete’s foot for more than six months. I use a cream that I found in a drugstore. It clears it up in about a week, but it comes back in about two weeks. How can I get rid of it once and for all? I’ve been told that wearing white socks cures it. – M.J.

ANSWER:
White socks don’t offer a cure. You’re dealing with a fungus that loves warm, moist places, the kind of environment that shoes and socks create for feet. Keeping the feet dry and cool goes a long way in eliminating the fungus. Sandals are in, and you should wear them as often as you can. Don’t wear the same pair of shoes on consecutive days. Give them a chance to dry.

You aren’t using the athlete’s foot medicine as long as you should. Continue its use for at least one week after the skin appears healed. Apply the medicine an inch past the borders of the infection. After six months of the same medicine, the fungus is probably resistant to it. Others abound. Tinactin, Nizoral, Lotrimin, Spectazole and Loprox are a few examples. They come as creams, gels, powders, sprays and liquids.

If skin-applied medicines don’t rid you of the fungus, you’ll have to see a doctor. One reason is confirmation of the diagnosis of athlete’s foot. It can be mistaken for some other skin condition. A second reason is the possibility of having to take an oral prescription medicine.

DEAR DR. DONOHUE: Why is sugar such a health hazard? – E.D.

ANSWER: Sugar isn’t a health threat. The three basic food categories are carbohydrates, proteins and fats. Sugar is in the carbohydrate category, along with starches. Most fruits, grains and vegetables are carbohydrates.

Sugar can lead to tooth decay. Sugary foods in excess promote obesity. Many sugar-based foods – soft drinks and candy – have little nutritional value. Such foods appeal to our taste and are fine to use in moderation. Moderation is the key.

DEAR DR. DONOHUE: My son had a physical exam in order to play baseball for his school. His urine test showed protein. Our doctor had the boy take many tests and finally came up with the diagnosis of orthostatic proteinuria. He said this is nothing. I still worry. What is it? – R.M.

ANSWER:
After a night asleep, your son’s urine has no protein. His urine shows protein only during the day, after he’s been standing. “Orthostatic” means “standing.”

This is a harmless quirk, found mostly in children and young adults. It resolves on its own. It’s not a sign of any serious kidney illness.

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. Readers may also order health newsletters from www.rbmamall.com.


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