So THAT’S why your eyes keep watering

94 WhydoIkeep gettingnosebleeds?

It cOULD be because of medication such as aspirin or blood thinners (for example warfarin), explains Professor Simon Lloyd, a consultant ent surgeon at the Manchester royal Infirmary. ‘this reduces the blood’s ability to clot, so if you hurt your nose it’s more likely to keep bleeding.

‘Or it may be down to high blood pressure, which can cause the blood vessels in the nose to burst. So your GP should check your blood pressure. the arteries also get stiffer when we are older, so are more prone to breaking — leading to bleeding.’

‘If there are no obvious causes and you get the nosebleeds more than once a week, you should be referred to a specialist so they can examine the nose with an endoscope — a type of camera,’ he says.

95 WhydoIneedto keepclearing mythroat?

tHIS may simply be down to not drinking enough, says ent surgeon Professor Simon Lloyd.

Another common cause is a post-nasal drip after a cold: excess mucus drips down the back of the throat, irritating it. ‘this tends to clear up shortly after recovering from the original cause,’ says Professor Lloyd. ‘But if it’s still an issue after six weeks it should be investigated.’

Anxiety can also cause the feeling of a lump in the throat, he says.

Another common cause is acid reflux, as this can irritate the throat. ‘Your GP should ask whether there have been other symptoms such as burping and heartburn,’ says Professor Lloyd. Antacids such as Gaviscon can help, as can cutting out fatty foods, red wine and chocolate. You may be prescribed proton pump inhibitors — drugs to reduce the amount of stomach acid produced. ‘ If acid reflux hasn’t been resolved after eight weeks you should be referred to a specialist,’ he advises.

96 Whycan’tIsmell anything?

Often there’s no obvious cause but typically it’s down to nasal polyps (tiny growths), explains ent surgeon Professor Simon Lloyd. ‘Your GP should be able to see this by examining inside the nose, though they will need to be experienced in this as scroll–like bits of bone in the nose can be mistaken for polyps.’

You’ll usually be given steroid nose drops or a spray. If these don’t help, oral steroids may work. ‘If there’s no sign of polyps the GP should check for itching or sneezing — an allergy can block the nose, affecting smell. It is important to exclude conditions such as diabetes which can affect smell through damage to nerves,’ says Professor Lloyd.

Sense of smell declines with age, he adds. ‘If there’s no obvious cause, it needs further investigation.’

97 Whydoesmy noserun whenIeat?

KnOwn as gustatory rhinitis, this is often triggered by hot and spicy foods and occurs because the taste nerves that give sensation to the tongue are supplied by the same nerve that links to the nose, explains ent surgeon Professor Simon Lloyd.

Unfortunately there isn’t really anything that can be done about it if this is the cause.

More rarely it could be because of an allergy, so a GP should check if it runs when eating a particular food.

In this case there may be other symptoms along with the runny nose, such as watery eyes.

98 What’smaking myeyes constantlywater?

In YOUnGer people — say, under 30 — it’s most likely to be an allergy, says Keith Davey, a consultant ophthalmologist at Huddersfield royal Infirmary. ‘eye drops with an antihistamine should help, or try over-thecounter tablets such as Zyrtec.

‘In all ages it can also be caused by cold weather or dry air which irritate the eyes. In older people, it’s probably down to a blocked tear duct. with age these can tighten up or they may be blocked with debris.

‘Your GP should refer you for investigation and the duct may need flushing with saline. If that doesn’t help, surgery may be needed to open the tear duct. there are different types of procedure but all are used routinely on elderly people,’ he says.

99 Howismacular degeneration treated?

tHIS age- related condition causes progressive sight loss as the macula, the part of the retina responsible for detailed central vision, becomes damaged.

‘If the GP suspects it’s agerelated macular degeneration (AMD) it’s important they send you to an optometrist as they will have the equipment to take a look at the eye before deciding if you need further treatment,’ explains ophthalmologist Dr Keith Davey. ‘treatment depends on the type.’

there are two types — wet and dry. wet AMD is the faster progressing, more serious type: it occurs when blood vessels form underneath the macula. ‘If the optometrist believes this is what you have you should be referred to a clinic within two weeks — it’s vital to move quickly to save vision,’ says Dr Davey.

It’s treated with injections of biologics into the eye every four to six weeks: this stops the growth of new blood vessels.

Dry AMD, which develops very slowly, is caused by a build-up of waste products. there’s no treatment, but patients are encouraged to eat a healthy diet with leafy green vegetables — these are rich in antioxidants such as lutein and zeaxanthin, which are good for the eye.

Dr Davey suggests it’s worth taking supplements containing the AreDS formulation — essentially high doses of vitamins A c and e, as well as zinc, lutein and zeaxanthin. trials suggest these may help slow progression of the disease. But check with your GP as high-dose vitamins can interfere with some medications.

‘It’s important to be aware of any changes as dry AMD can sometimes progress to the wet form, so if you experience any sudden deterioration go back to the optometrist — rather than your GP,’ says Dr Davey.