DEAR DR. ROACH: I have celiac disease and have been put on a gluten-free diet. I have been reading labels of cake mixes and other products. They don’t say that they contain gluten. Other products say “gluten-free.” If it doesn’t say “gluten” in the ingredients, does that mean it’s gluten-free? — G.W.

ANSWER: Celiac disease, or celiac sprue, is sensitivity to a protein found in specific grains. People with this increasingly diagnosed condition need to be very careful to avoid gluten, or they are unable to properly digest food. Products that are marked free” are your safest bet.

If you aren’t sure, look carefully at the ingredients. If it contains wheat flour (or just “flour”), rye or barley, then you can’t have it. However, there are several other names to look out for. Bulgur, semolina, couscous, einkorn, farina, faro and spelt are all examples of different types of wheat or wheat products. Malt and malt flavoring are barley products.

Because this condition is increasingly recognized, there are many more options for gluten-free cooking, and many grocers have special sections for gluten-free products. The Celiac Disease Foundation has resources to help.

DEAR DR. ROACH: I am 84, and I have what is called dry eyes. My eyes water so much that it affects my vision — my eye doctor said surgery may or may not work. Do you have any help for me? — D.M.

ANSWER: I have received a lot of letters recently about dry eyes. Many conditions can cause the symptom of dry eyes. Medications (including high blood pressure medicines), contact lenses, LASIK surgery, certain autoimmune diseases and skin conditions all may cause it.

The most common cause is normal aging. It may seem strange that you complain of watery eyes; however, watery eyes are paradoxically common in dry eye syndrome. As the dry eyes get irritated, they can reflexively water with a different kind of fluid.

This doesn’t help, because this liquid doesn’t have the same qualities for lubricating as normal tears do. Dry eyes often are worse in dry or dusty areas and when watching television or reading; they’re better in areas of high humidity.

For most people with mild or moderate symptoms, using artificial tears every few hours is effective at relieving symptoms. It’s also important to keep the eyes lubricated to prevent scratching of the outer layer of the eye. Lubricating ointments are useful at nighttime (but never with contact lenses). Moderate cases may need prescription eyedrops.

Surgery usually is not considered except in severe cases. In surgery, the ophthalmologist plugs the puncta, the small openings in the eye that allow tears to drain into the nose. By blocking these, both natural and artificial tears stay in the eye longer. Very severe cases may require different kinds of surgeries.

Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected] or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Health newsletters may be ordered from

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