ASK THE GP: How to treat those constantly watery eyes? Dr Martin Scurr answers your health questions
Over the past 12 months I’ve had a constant watery eye. Now it’s happened to the other one and it’s so annoying. I recently saw an optician who suggested bathing my eyes with pads dipped in hot water. But it’s made no difference. What more can I do?
Mary Stock, Newport.
Watery eyes have a variety of causes. Some are short-lived and will be obvious, such as infection of the cornea (keratitis), an allergy or a stye (an infection that leads to a tender lump near the eyelid).
In these cases, the watering is a result of an irritant to the eye causing excess tear production (one role of tears is to wash out dirt), and the watering will cease once the cause of irritation goes.
Did you know? Dry eyes are typically the result of a problem with the meibomian glands in the upper and lower eyelids
However, as the optician advised you to bathe your eyelids with pads soaked in hot water, this suggests they think you have dry eye syndrome. This might seem confusing — that dry eyes lead to excess tears — but let me explain.
Dry eyes are typically the result of a problem with the meibomian glands in the upper and lower eyelids. These glands secrete the oil that helps encase tears, minimising the evaporation of the watery fluid.
However, if the glands become blocked, the lack of oil means the tears evaporate more easily, causing dry patches on the eye itself.
In response, more tears are produced; but, missing the stabilising effects of oil, these then tend to spill over the eyelid edge.
Your optician suggested using hot water bathing — good advice as heat can help melt any thickened oil clogging the glands and improve the output of the gland, too. However, you need to continue for some weeks to see the benefit.
It may improve the results if you use an eye pad containing linseed (available from opticians and chemists) that can be warmed in a microwave. This can then be applied to the eyes, while reclining, for ten minutes twice daily.
Production of oil by the meibomian glands is improved by this technique, as it boosts the blood flow to the eyelid margins and the Meibomian glands are more active when the blood supply is greater.
I have threadworms. I have bought Ovex tablets from my chemist but I still have the problem. I have washed everything in the house. I am at my wits’ end.
Name and address supplied.
Threadworms infest the colon and rectum and are particularly common among the under-tens.
You are correct to take Ovex, the drug mebendazole, at a single dose of 100mg. Mebendazole is also available in liquid form for children.
The infection is easily transferred, so it is wise to treat every member of a household.
Threadworm cause a persistent itch in the anal area, and children tend to scratch, particularly at night, when the worms — which look like lengths of white cotton — come out to lay eggs
Write to Dr Scurr
To contact Dr Scurr with a health query, write to him at Good Health Daily Mail, 2 Derry Street, London W8 5TT or email [email protected] — including contact details.
Dr Scurr cannot enter into personal correspondence.
His replies cannot apply to individual cases and should be taken in a general context.
Always consult your own GP with any health worries.
Threadworm cause a persistent itch in the anal area, and children tend to scratch, particularly at night, when the worms — which look like lengths of white cotton — come out to lay their eggs.
Mebendazole kills the worms within days, but not the eggs. Accordingly, when residual eggs hatch, the infestation will continue. So a second dose 14 days later will break the cycle.
Why you continue to suffer is unclear.
If you can see threadworms, then take a double dose, i.e. 200mg (as some infections are resistant to treatment) and repeat after 14 days If there are no worms, it might be that you have pruritus ani, a chronic itching around the anal area that can be triggered by a threadworm infection.
I suggest you request a Sellotape slide test from your GP. This involves applying a 5 cm length of clear sticky tape over the anus and then sticking this on a glass slide provided.
This is examined under a microscope. If eggs are present, there is a continuing infection; if not, you have pruritus ani.
If the latter is the case, wash the area with aqueous cream and apply one per cent hydrocortisone cream (no prescription is necessary) twice daily for about two weeks.
IN MY VIEW: GPs really can’t carry on like this…
EVERY couple of months I get a call from a GP friend guaranteed to cause me despair.
He’s one of two partners at what is meant to be a five-partner practice. In the past couple of years, two left for health or family reasons and a third quit as the job made him feel more like a pen‑pusher than a clinician.
Now, the two remaining are seeing up to 50 patients a day, constantly fearful they’re not delivering the level of care this community deserves.
As the Mail reported last week, record numbers of GP surgeries shut down last year — 138 in all. If it weren’t for the sense of loyalty my friend and his partner feel towards their patients, that figure would be 139.
The truth is doctors don’t want to be GP partners any more. The administrative tasks, regular inspections and annual appraisals can be seriously off-putting. Doctors can instead earn excellent money as locums, with none of the responsibilities of looking after the buildings, staff, number-crunching and box-ticking that being a GP partner entails.
Then you have the fact that 70 per cent of those coming out of GP training are now women, and they are more likely to work part-time as they juggle their job alongside raising a family.
Senior GPs are increasingly taking early retirement as new regulations mean they’re penalised if they carry on earning and adding to pension pots.
The Government must cut through the red tape that’s so off-putting for young GPs while addressing the issues for the old hands. Unless it does this, last week’s troubling figures will represent the mere start of a crisis that has yet to peak.
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