Description and Possible Medical Problems

Do you have cracks in the corners of your mouth that never quite seem to heal? You apply Vaseline, lip balm, and maybe even an over-the-counter bacitracin ointment, but nothing seems to help.

This annoying problem is called angular cheilitis, or perleche, and is caused by any one of a number of underlying conditions. The most common cause is dentures that no longer fit properly. When this happens, your bite is naturally altered, and the dentutes may rub against the insides of your mouth, causing irritation and sores in the corners of your mouth that never totally disappear.

Another less common cause of angular cheilitis is a vitamin B deficiency. Do you eat a lot of refined foods made with white flour and other processed grains? If you have cracks in the corners of your mouth and you don’t wear dentures and your bite hasn’t changed recently, you may need to eat more foods that are rich in vitamin B (see page 149), as well as taking a vitamin B supplement.

Treatment

Cracks in the corners of your mouth are relatively simple to treat; all you have to do is address the underlying cause.

If you believe that poorly fitting dentures are the cause of your cheilitis, you should visit your dentist, who will make the necessary adjustments in your dental appliance. After wearing the newly adjusted denture for a few days, the cracks in the corners of your mouth should disappear.

If you don’t wear dentures, and you know that your diet is low in vitamin B, you can start to cure the cracks in the corners of your mouth by eating whole-grain breads and cereals instead of refined ones. It’s also a good idea to take a B-complex vitamin supplement, which will quickly help clear up the cracks.

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Description and Possible Medical Problems

Small children are no strangers to the pain of ear infections, which can cause the ear to feel very full, but adults in midlife years and older can get them, too, though they tend to occur less often. Ear infections are sometimes accompanied by pain and fever.

If you suddenly lose some of your ability to hear and also have a fever and an earache, and/or you feel nauseous, you probably have an ear infection known as otitis media. You may also feel dizzy and be aware of a faint buzzing in your ears.

There are four kinds of otitis media, which range from mild to severe. In serous otitis media, fluid is present in the middle ear, while in otitis media with effusion, fluid also collects in the middle ear but is accompanied by an infection. Secretory otitis media alters the cells that line the middle ear so that the trapped fluid thickens and oozes from the ear. In acute purulent otitis media, pus accumulates in the middle ear, making it the most dangerous type of ear infection since the pus can build up enough pressure to burst the eardrum.

Treatment

Since it’s difficult to know which of the four types of otitis media you have, it’s important to see your physician whenever you have an ear infection. She will probably prescribe a decongestant such as Seldane, Claritin, or Hismanal for you to take for two weeks or longer, which will help to unclog the middle ear. She may also prescribe an antibiotic such as penicillin or Keflex when an infection is present. An untreated infection can lead to a chronic ear infection, which, in some cases, can lead to permanent hearing loss.

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Description and Possible Medical Problems

If you suddenly lose all or part of your ability to see on one side of your entire field of vision, and if your eyesight decreases markedly over the course of only a couple of hours, you must see your doctor immediately because this is a sign of a stroke.

A stroke, also known as a cerebrovascular accident, occurs when the flow of blood to the brain is interrupted, even for as little as a minute. A stroke can be due to several different types of blockage. In one type of stroke, called a cerebral thrombosis, the arteries that supply blood to the brain have become lined with plaque (this is known as arteriosclerosis). A blood clot may form where the plaque lines the artery and eventually block the flow of blood to the brain. In a cerebral embolism, a blood clot or a small piece of plaque or arterial wall from another part of the body breaks off and travels through the arteries until it lodges in an artery, creating a blockage. Another type of stroke is a cerebral hemorrhage, in which the affected artery starts to leak or ruptures and blood flows into the brain. The accumulation of blood can then create pressure on the parts of the brain in which it masses and clots, cutting off the flow of blood and oxygen to the brain. If your loss of vision is accompanied by a severe headache, you have probably had a cerebral hemorrhage.

The loss of vision symptoms for all three types of stroke are similar, except that a cerebral hemorrhage usually causes more damage and is more often fatal than the other two are.

Stroke is most common in men and women over 60, but men are more prone to stroke and die more frequently from it. About one third of all strokes are fatal, while another third leave the person with permanent damage. Nevertheless, one third of all stroke victims suffer no permanent damage at all. If you fall into this last category, you may have had a transient ischemia attack, or TIA, which is a mild form of stroke in which the blockage and impaired vision last less than 24 hours. With a cerebral thrombosis or cerebral embolism, the symptoms tend to be permanent.

If you have had a TIA, you should begin treatment for arteriosclerosis immediately, since a TIA is an indication that you will probably have another stroke—perhaps a more serious one the next time around.

Treatment

If you have experienced a sudden loss of vision due to a stroke, your doctor will administer a series of tests in order to make a positive diagnosis. These may include an electrocardiogram, X rays, and possibly a CAT scan to determine which parts of the brain have been injured. To reduce the risk of a TIA or stroke recurring, your doctor will prescribe medication that will help control your high blood pressure, a daily dose of aspirin, which serves as an anticoagulant and discourages future clots from forming, and a low-salt and low-fat diet, which will also help lower your blood pressure.

Your vision will probably return to normal after a TIA; with a cerebral thrombosis or embolism, the damage may be permanent.

In some cases, surgery to remove arterial plaque may be necessary.

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Description and Possible Medical Problems

We are all affected by blurred vision at one time or another. Fatigue, poor light, and alcohol can all make it difficult to focus clearly. And when you wear eyeglasses or contacts and it’s time for a stronger prescription, your vision may be blurred more frequently.

If objects occasionally appear blurry to you and your eyesight is otherwise good, whether it’s corrected by lenses or not, the condition is usually temporary and easy to treat. Blurriness is usually due to changes in the pupil, the part of the eye that is the first to react when our line of vision changes in some way.

The pupil is a black disk in the center of the colored part of the eye, which is called the iris. The pupil’s function is to regulate the amount of light that enters the eye, and it is controlled by involuntary muscles that respond to stimuli. Around the age of 50, as is true of many other parts of your body, the pupil’s reflexes start to decrease somewhat; it may take just a bit longer for the pupil to dilate or contract in response to the amount of light it can detect. This slowed reaction due to aging is a given, and there’s nothing you can do to improve it. The pupil can also become wider or more narrow in response to certain medications, such as atropine, which is prescribed to calm an irritable or spastic bowel, pilocarpine, or cocaine, as well as when you’re physically or mentally excited.

With many of the problems that occur in the eye, blurred vision is one of several symptoms including headache, dizziness, and bright flashes of light. However, if blurred vision appears by itself slowly over time with no other symptoms, the problem is usually easy to fix. The solution will probably lie in your glasses or contact lenses.

Treatment

The first thing to do if your vision is blurry is to check your glasses or contacts to see if they’re dirty or smeared. Frequently, blurred vision is caused by a problem with your corrective lenses, whether they’ve been scratched or just need cleaning. If you’ve worn the same nondis-posable pair of contact lenses for more than a year, the protein buildup on the lenses can be so extensive that even the recommended weekly enzyme cleaners won’t remove it. Sometimes a slight tear in a contact lens can also cause blurred vision, so it’s a good idea to check for this as well.

If you wear glasses, examine the lenses for scratches. Even scratch-resistant lenses can become marred.

After you clean your glasses or contact lenses thoroughly, your vision should be crystal clear. If, however, your vision is still blurry, see your eye doctor. All you may need is a stronger prescription.

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TREATMENT

No matter what the cause, damage to the cornea can be healed within a few days with proper treatment. If the culprit is a scratcl or injury by a foreign particle or a bacterial infection, your doctor may prescribe an antibiotic ointment such as Cortisporin or gen tamicin ointment for you to use two or three times daily for a few days until the injury heals. When the herpes simplex virus is the cause, your physician may prescribe a special antiviral medication such as Zovirax to apply topically in either eyedrops or ointment.

If a corneal ulcer or infection is caused by a fungus, the ulcer is usually invisible to the eye, but it will be painful. If this happens, your doc tor will recommend an antifungal medication, though a fungal infection can be stubborn and may reappear in the future.

Regardless of what caused the damage to your cornea, you should take care never to touch your eyes while they’re healing, as foreign matter or a new bacterial, fungal, or viral strain can be introduced very easily, prolonging the corneal infection.

Tips and Precautions

Whenever you have an eye infection, you should be careful to follow this advice:

1. Never use eyedrops or ointments from a previous infection.

2. .Wash your hands frequently, especially after you touch your eye.

3. Take a break from wearing contact lenses until your doctor tells you otherwise.

4. When you do have to touch the infected eye, don’t touch the other one, as this can easily spread the infection.

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