ET

Doctor's Diary (Filed: 17/07/2001)

Seeing haloes, asks Dr James Le Fanu. Then you need help

THE celebrated T E "Peter" Utley commissioned my first ever article for The Daily Telegraph back in 1984. It was only recently, however, that I learnt from his son Tom's weekly column that his blindness was due to the sudden rise in pressure within the eyeball known as acute glaucoma. This is, thankfully, a treatable condition nowadays but medication has to be started within the first 48 hours of the onset of symptoms - pain, redness and deterioration of vision - if the eyesight is to be preserved.

The hazards of acute glaucoma can be avoided if heed is taken of warning signs which usually occur when the person is sitting in semi-darkness (as in a cinema), where the pupil dilates to compensate for the low lighting. This causes a transient pressure rise, which results in eye pain or the perception of coloured haloes around bright objects. This should act as a signal to make an urgent appointment with your optician for a check-up.

The pain and tenderness of repetitive strain injury come in many forms. The best known, a common problem at Wimbledon over the past fortnight, is tennis elbow, in which the wrist movement required to send the ball spinning back over the net inflames the tendons of the long muscles where they join the bone at the top of the radius. Golfers get a similar pain, on the inner elbow, from stressing the muscles required to whack the ball down the freeway.

Cane cutters' wrist is a serious occupational hazard for labourers during the sugar harvest, while a milder form of the syndrome - as the same muscles are involved - may affect middle-aged males after a weekend's unaccustomed house painting.

Then there is "centenarians' hand" caused by over-rigorous handshaking, so called because it was first identified in a centenarian the day after greeting all the well-wishers at his birthday celebrations.

Now I am pleased to announce a never-previously described variant - Hornby hand. Nick Hornby's latest book, How To Be Good, has been a best seller for the past five weeks.

He contacted me last week because of a mysterious pain in the right hand, which he feared might interfere with his forthcoming American tour.

Following a few discreet inquiries, it emerged that he had spent much of the previous fortnight at events signing piles of his books - and this could only too easily account for his symptom.

Treatment with anti-inflammatory drugs, plus steroid injections, is usually highly effective while Judy Swain, a physiotherapist from Essex, advises oiling the site of the tenderness and then placing an ice-pack over it for five to 10 minutes, twice a day.

There's been an interesting suggestion that the dry mouth and vivid dreams as described by Mr CS from Bolton, Lancashire, may be related to the syndrome of loud snoring and disturbed sleep caused by partial obstruction of the airways by the soft palate, known as obstructive sleep apnoea.

A reader from Oxfordshire writes to say she has a similar problem. She has tried out several possible remedies including sewing tennis balls into her pyjamas to stop her sleeping on her back.

But the most successful - which I admit not having heard about before - turns out to be sticking her mouth shut with a narrow strip of micropore (this must only be attempted by those who can breathe freely through their nostrils).

"These vertical plaster strips across the lips have proved the most practical and effective measure," she writes. "I have monitored my snoring with a voice-activated sleep recorder and it is much more muted and regular than before. And I no longer wake with the horrid sensation of a dry mouth."

On the two recent grittiness problems, a Chesterfield reader speculates that gritty eyes and mouth may be an early presentation of Sjogren's Syndrome, in which the mucus membranes dry up. "Many go undiagnosed until their symptoms become more pronounced," she writes. "Artificial tears and sugar-free chewing gum work wonders for me."

As for the gritty mouth and occasionally protruded white chalky specks described by Mrs JM, a reader from Guildford says she should look inside her kettle, which may be in need of de-scaling.

Mrs CT from Essex writes on behalf of her 17-year-old daughter Jenny to ask for advice on how to alleviate her "excruciating and debilitating periods".

"She is completely unable to function for two days, lying immobile in the foetal position, trying not to faint and be sick. Even moving her arm from beneath her stomach to ease a tight watchstrap made her cry."

Next, Mrs CM from north London writes to ask whether it could be true - as she was advised by her gynaecologist - that the cause of her recurrent exacerbations of cystitis was coloured lavatory paper.

-- Anonymous, July 20, 2001