The messy drops I use for my sore eyes just don’t work. What will?

SINCE having radiotherapy for cancer in my neck, I’ve suffered terribly from what I’ve been told is dry eye syndrome. My eyes are sore and watery, and I keep getting eye infections. I’ve tried various eye drops, four times a day, but they’re messy and if I miss a dose, the symptoms return with a vengeance. Anything else I can do?

THE symptoms of dry eye syndrome are due to inflammation of the surface of the eye – caused by a lack of tears. I’m not talking about crying – tears are moisture produced constantly by the eyes, which keep them healthy, washing away debris and acting as a protective film.

When we don’t produce enough, it can make life uncomfortable – and this also can affect vision.

After radiotherapy to the head and neck, there can be damage to the glands in the eye that make tears – known as lacrimal gland fibrosis – and this will cause dry eyes. It’s a chronic condition, which means we can’t cure it. But there are things you can do to help rather than simply applying eye drops.

Reducing computer use and avoiding air conditioning is a good idea, if this is possible.

When we look at screens, we tend to blink far less, which exacerbates dry eye syndrome. So, when using a computer, it’s worth consciously thinking about blinking more.

Increasing humidity in the home, for example with a humidifier, might help, too.

Cigarette smoke worsens dry eyes, so making sure no one in the house smokes is vital.

Artificial tears or lubricant eye drops are recommended: drops are best for using in the daytime, whereas you can use ointment or gels before bed. Trial and error may be needed to find the one that works for you.

If a sufferer has been using a combination of drops for more than three or four months with no improvement, a specialist may recommend surgical treatment to the eye drainage system if the condition is badly affecting quality of life.

I HAVE a heart problem, atrial fibrillation, and was prescribed a medicine called edoxaban which stops my blood clotting, reducing my stroke risk. Unfortunately, it caused horrible itching all over my body. A similar drug, riveroxaban, has the same side effect. I know many people in America just take aspirin. Couldn’t I do this too, and save myself all the bother?

ATRIAL fibrillation (AF) is a condition where the heart beats too fast and with an irregular rhythm. It’s thought to affect 1.25 million people in the UK and sufferers are at a high risk of having a stroke.

The abnormal beating of the heart causes erratic blood flow, and small clots develop which can travel to the brain, cutting off the circulation.

For this reason, blood-thinners, also known as anticoagulants, are usually recommended to deal with AF.

Modern blood-thinning drugs, collectively known as NOACs, are the first type of treatment we try.

But there are side effects to these drugs. Significant pruritus or itching may be one, and if this is the case, warfarin – an older blood-clotting drug – would be the next best option.

Aspirin has a blood-thinning effect, but isn’t effective at preventing stroke in AF. This has been shown in scientific studies so it is no longer licensed in the UK for either of these things.

Only an NOAC or warfarin is proven to work to prevent stroke, so that’s what is recommended.

I AM thinking about taking a Vitamin D supplement, as recommended. Would it interact with other medicines or cause side effects?

VITAMIN D is vital for healthy bones, muscles and for the immune system. Unlike most vitamins, our main source isn’t food – only small amounts can be gained from things such as eggs or fish. In fact, Vitamin D, technically a hormone, is mostly made naturally by our own bodies, in the skin, in response to UV light from the sun. Official advice is that everyone needs at least 10 micrograms of Vitamin D a day. In the winter, when there’s not so much sun, we should all take a supplement.

During the pandemic, the Government also said that more than 2.5 million Britons – mainly those who were shielding, or were in care homes and unable to g outdoors – would get free Vitamin D supplements.

For anybody considering taking a vitamin D supplement, a dose of 25 micrograms a day is standard. This dose may be called 1,000 units or ‘iu’ on some supplements.

Of course, some people need a higher dose – if you’ve been given a blood test, and identified as deficient, for example.

Side effects aren’t really seen, even in those who take large amounts. But Vitamin D isn’t recommended for patients who have kidney problems, or problems with their calcium levels.

There is a theoretical risk of taking Vitamin D supplements along with diuretics, often prescribed for high blood pressure, because both put additional stress on the kidneys. People on diuretics should avoid taking anything higher than the standard supplement.

Anyone on medications should discuss with their pharmacist before buying any supplements to avoid interactions.