Tears are needed to keep the front surface of the eye healthy and maintain clear vision. Too many tears can make it difficult to see, however.

Epiphora can develop at any age. It is, however, more common among babies aged under 12 months, and adults over the age of 60 years. The condition may present symptoms in just one or both eyes.

In most cases watering eye can be treated effectively. Depending on the severity of symptoms, watering eye can sometimes make driving difficult and dangerous.

There are two main causes of watering eyes – blocked tear ducts or excessive production of tears. Let’s look at each of these in turn.

Blocked tear ducts

Some humans are born with underdeveloped tear ducts. It is not uncommon for newborns to have watery eyes. Generally, this problem goes away within a few weeks as the ducts develop.

If a patient’s tear ducts are narrowed or blocked their tears will not be able to drain away and will build up in the tear sac. Stagnant tears in the tear sac increase the risk of infection in that area and the eye will produce a sticky liquid, further exacerbating the problem. Infection can also lead to inflammation on the side of the nose, next to the eye.

Narrow drainage channels on the insides of the eyes (canaliculi) can become blocked. This is caused by swelling or scarring.

Over-production of tears

Irritated eyes may produce more tears than normal as the body tries to rinse the irritant away.

The following irritants can cause the over-production of tears:

• Some chemicals, such as fumes, and even onions
• Infective conjunctivitis
• Allergic conjunctivitis
• An injury to the eye, such as a scratch or a bit of grit (tiny pebble or piece of dirt)
• Trichiasis – inward-growing eyelashes, often caused by marginal entropion (the eye lid turns in at the edges towards the eye)
• Ectropion – this is when the lower eyelid turns outwards.

The tears of some patients have a high fat (lipid) content. This may interfere with the even spread of liquid across the eye, leaving dry patches which become sore, irritated and cause the eye to produce more tears.

Other causes

There are many causes of watering eyes. The following conditions among others can also lead to an overflow of tears:

• Keratitis, an infection of the cornea
• Corneal ulcer, an open sore that forms on the eye
• Styes or chalazions, lumps that can grow on the edge of the eyelid
• Bell’s palsy
• Dry eyes
• Allergies, including hay fever
• A problem with glands in the eyelids called the Meibomian glands
• Use of certain medications

Diagnosis

If the GP cannot clearly determine the cause of the watering eye, the patient may be referred to an eye-care specialist doctor (ophthalmologist). The specialist will examine the patient’s eye(s) carefully – usually, the patient will be anesthetized.

A probe might be inserted into the narrow drainage channels on the inside of the eye (canaliculi) to see whether they are blocked.

Liquid may be inserted into a tear duct to find out whether it comes out of the patient’s nose. If it is found to be blocked, a dye may be injected to find the exact location of the blockage – this will be done by using an X-ray image of the area. The dye shows up on the X-ray.

Treatments

Treatment options depend on the severity of the epiphora and its causes. In mild cases doctors may recommend just watchful waiting – doing nothing and monitoring the patient’s progress.

Different causes of watering eyes have specific treatment options:

• Irritation: If the watering eye is caused by infective conjunctivitis the doctor may prefer to wait for a week or so to see if the problem resolves itself without antibiotics.
• Trichiasis: An inward-growing eyelash, or some foreign object that lodged in the eye, the doctor will remove it.
• Ectropion: The eyelid turns outwards – the patient may need to undergo surgery in which the tendon that holds the outer eyelid in place is tightened.
• Blocked tear ducts: Surgery which creates a new channel from the tear sac to the inside of the nose may be necessary. This allows the tears to bypass the blocked part of the tear duct. This surgical procedure is called DCR (dacryocystorhinostomy).

If the drainage channels on the inside of the eye (canaliculi) are narrowed, but not entirely blocked, the doctor may use a probe to make them wider. When the canaliculi are completely blocked an operation may be required.

In the majority of cases the condition resolves itself on its own within a few weeks. Sometimes a sticky liquid may form around the baby’s eye(s). In such cases, using a piece of cotton wool that has been soaked in sterile water can be used to clean the eye(s). Sterile water needs to be boiled – make sure it is cooled before dipping the cotton wool into it.

Sometimes tears can be dislodged if you gently massage the tear ducts. Apply light pressure with the finger and thumb to the outside of the baby’s nose.

• Tonsils and adenoids are composed of tissues similar to the lymph nodes or glands.
• Acute tonsillitis is an infection of the tonsils caused by one of several types of bacteria or viruses.
• Chronic tonsillitis is a persistent infection of the tonsils and can cause tonsil stone formation.
• Signs and symptoms of tonsil or adenoid infection include:
  • Sore throat
  • Fever
  • Bad breath
  • Difficulty swallowing
  • Swollen lymph glands in the front of the neck
• Peritonsillar abscess is a collection of pus behind the tonsils.
• Obstruction to breathing by enlarged tonsils and adenoids may cause snoring and disturbed sleep patterns.
• Bacterial infections of the tonsils and adenoids are treated with antibiotics, viral infections are not.
• Tonsillitis and adenoid infections are diagnosed with a history and physical exam. A throat culture and rapid strep test may be ordered in cases of tonsillitis suspected to be bacterial.
• Tonsillectomy and adenoidectomy (surgical removal of the tonsils) may be recommended: (1) for repeated or persistent infections; (2) when serious complications of infection occur; and (3) when enlargement of the tonsils and adenoids causes breathing, swallowing, or dental problems.

The tonsils and adenoids are composed of tissues similar to the lymph nodes or glands found in the neck or other parts of the body. Together, they are part of a ring of glandular tissue (Waldeyer’s ring) encircling the back of the throat.

The tonsils are the two masses of tissue on either side of the back of the throat. Normal tonsils are usually about the same size and have the same pink color as the surrounding area. On their surfaces are little depressions, called crypts, which may appear deep and contain pus pockets or tonsil stones.

The adenoids are located high in the throat behind the nose and soft palate (the roof of the mouth) and unlike the tonsils, are not easily visible through the mouth. A tonsillectomy and an adenoidectomy (commonly referred to as a T & A) are surgical procedures performed to remove the tonsils and adenoids.

The tonsils and adenoids are thought to assist the body in its defense against incoming bacteria and viruses by helping the body form antibodies. However, this function may only be important during the first year of life. There is no evidence to support a significant role of the tonsils and adenoids in immunity. Medical studies have shown that children who have their tonsils and adenoids removed suffer no loss in their future immunity to disease or ability to ward off infections.

The most prominent symptom of tonsillitis and adenoid infection is a sore throat. Other signs and symptoms of tonsillitis and adenoid infection include:

• Fever
• Bad breath
• Congestion and runny nose
• Swollen lymph nodes in front of the neck
• Red, swollen tonsils with patches of pus (white spots)
• Pain or difficulty swallowing
• Loss of voice or muffled voice
• Headache
• Abdominal pain
• Coughing up blood
• If the adenoids are enlarged, breathing through the nose may be difficult and symptoms may include:
  • Breathing through the mouth, especially in children
  • Noisy breathing in the day; snoring at night is often observed
  • Nasal-sounding voice

When there is a sore throat and cold symptoms such as congestion, runny nose, sneezing, and coughing, the cause is most likely a virus. Viral infection of the tonsils or adenoids usually resolves without treatment within two weeks.

Sore throat with a sudden mild fever, without symptoms of an upper respiratory tract infection, may point to a bacterial infection. If these symptoms are present, see a doctor for diagnosis because of the risk of strep throat. Although strep throat will usually go away even without treatment, an untreated strep infection can lead to complications including rheumatic fever, which can permanently damage the heart.

Picture of bacterial and viral tonsillitis

• Difficulty breathing through the nose
• Nasal congestion, usually one side more than the other
• Recurrent sinus infections
• Nosebleeds
• Sleep problems, such as contributing to loud snoring or sleep apnea
• Headache postnasal drip

How is deviated septum diagnosed?

Your health care professional can diagnose a deviated septum during the physical examination. Usually a bright light and an instrument that can help visualize the nasal septum by opening the nostril (nasal speculum) will help make the correct diagnosis. Some deviated septums are deep in the nose and may require further evaluation in the office with a small telescope or endoscope. Imaging may occasionally be done with a CT scan to view the extent and other associated to findings, but this is not often done.

A deviated septum is an extremely common condition and many people with a deviated septum do not need treatment.

Some symptoms such as a stuffy nose or postnasal drip may be alleviated with medication, including decongestants, antihistamines, or nasal sprays. In many cases, medications are tried before surgery is recommended.

If a person has a deviated septum and it causes breathing problems or sleep apnea and snoring, surgery may be recommended to repair the septum. Surgery to fix a deviated septum is called a septoplasty, submucous resection of the septum, or septal reconstruction.

See your doctor about a deviated septum if you have:

• trouble with nasal breathing,
• sleep problems (particularly sleep apnea), or
• chronic sinus problems.

A deviated septum may cause any of these problems, however, there are other reasons these symptoms may occur and it is important to see a doctor for a correct diagnosis and treatment. 

Nasal polyps are common, noncancerous, teardrop-shaped growths that form in the nose or sinuses. They’re usually found around the area where the sinuses open into the nasal cavity. Mature ones look like peeled grapes.

Often linked to allergies or asthma, they may cause no symptoms, especially if they’re small and don’t need treatment. Larger ones can block normal drainage from the sinuses. When too much mucus builds up in the sinuses, it can become infected.

Unlike polyps that form in the colon or bladder, nasal ones are rarely cancer. Experts think that long-term inflammation causes them or that they run in families.

Nasal polyps aren’t painful to the touch. Medications or surgery can treat most. They may come back, though.

If you have any symptoms, they may include:

• Stuffy or blocked nose
• Sneezing
• Postnasal drip
• Runny nose
• Facial pain
• Trouble with sense of smell
• Loss of taste
• Itching around the eyes
• Infections

Many people also have wheezing, sinus infections, and sensitivity to fumes, odors, dusts, and chemicals. It’s less common, but some people with nasal polyps also have a severe allergy to aspirin and reaction to yellow dyes. If you know you have that allergy, ask your doctor to check for nasal polyps.

Nasal polyps make you more likely to have long-term (chronic) sinusitis. Large ones can even change the shape of your nose.

Anyone can, but they’re most common in adults over age 40 and are twice as likely to affect men as women. Children under age 10 rarely get them. If they do, a doctor will check for signs of cystic fibrosis.

Nasal polyps are linked to allergic rhinitis, asthma, aspirin allergy, sinus infections, acute and chronic infections, something stuck in the nose, and cystic fibrosis. But many times the cause is unknown. Sometimes, people get them before they develop asthma or sinusitis.

Some experts think that symptoms of allergies — including runny nose, sneezing, and itching — make some people more likely to get nasal polyps. But the allergy connection is controversial. Other researchers think that sinus infections are to blame.

If you think that you have nasal polyps, your doctor can check. She’ll use a nasal endoscope, which is a tool with a magnifying lens or camera that provides a detailed view of your nose and sinuses. In some cases, your doctor may order more tests or take a small sample (a biopsy) of the polyp.

If you need treatment, you’ll probably start with a nasal corticosteroid spray. In many cases, that can shrink or even get rid of nasal polyps. But some people need to take corticosteroids such as prednisone by mouth for a week.

Unfortunately, nasal polyps tend to come back if the irritation, allergy, or infection continues. So you may need to keep using a corticosteroid spray and get checkups with a nasal endoscope every now and then.

What Happens in a Nasal Allergy Attack?

Sometimes, nasal polyps are so large that corticosteroid nasal sprays don’t work. In such cases, surgery may be an option.

The doctor would likely use a small nasal telescope that removes nasal polyps. You can go home the same day as the surgery.

Surgery helps in most cases. It may be less effective if you have nasal polyps, asthma, and aspirin sensitivity. If that’s you, medication may be more helpful.

Macular degeneration is the leading cause of severe vision loss in people over age 60. It occurs when the small central portion of the retina, known as the macula, deteriorates. The retina is the light-sensing nerve tissue at the back of the eye. Because the disease develops as a person ages, it is often referred to as age-related macular degeneration (AMD). Although macular degeneration is almost never a totally blinding condition, it can be a source of significant visual disability.

If you’re in the early stages of age-related macular degeneration you may not have symptoms. The first sign you may notice is a gradual or sudden change in the quality of your vision or that straight lines appear distorted to you. This may gradually turn into a dramatic loss of your central vision.

Other symptoms include:

• Dark, blurry areas or whiteout that appears in the center of your vision
• In rare cases, you may have a change in your perception of color

For age-related macular degeneration, you should see a doctor called an ophthalmologist. They specialize in eye care and surgery.

In general, if you’re older than 45 you should get a complete eye exam and then follow-up exams every 2 to 4 years.

If you have age-related macular degeneration, check your vision every day and let your doctor know if you notice any changes.

Keep in mind that vision problems could also be signs of another condition besides macular degeneration. Work with your doctor to get the right treatment for you.

When the taste cells are stimulated, they send messages through three specialized taste nerves to the brain, where specific tastes are identified. Taste cells have receptors that respond to one of at least five basic taste qualities: sweet, sour, bitter, salty, and umami [oo-MOM-ee]. Umami, or savory, is the taste you get from glutamate, which is found in chicken broth, meat extracts, and some cheeses. A common misconception is that taste cells that respond to different tastes are found in separate regions of the tongue. In humans, the different types of taste cells are scattered throughout the tongue.

Taste quality is just one way that you experience a certain food. Another chemosensory mechanism, called the common chemical sense, involves thousands of nerve endings, especially on the moist surfaces of the eyes, nose, mouth, and throat. These nerve endings give rise to sensations such as the coolness of mint and the burning or irritation of chili peppers. Other specialized nerves create the sensations of heat, cold, and texture. When you eat, the sensations from the five taste qualities, together with the sensations from the common chemical sense and the sensations of heat, cold, and texture, combine with a food’s aroma to produce a perception of flavor. It is flavor that lets you know whether you are eating a pear or an apple.

Most people who think they have a taste disorder actually have a problem with smell. When you chew food, aromas are released that activate your sense of smell by way of a special channel that connects the roof of the throat to the nose. If this channel is blocked, such as when your nose is stuffed up by a cold or flu, odors can’t reach sensory cells in the nose that are stimulated by smells. As a result, you lose much of our enjoyment of flavor. Without smell, foods tend to taste bland and have little or no flavor.

Some people are born with taste disorders, but most develop them after an injury or illness. Among the causes of taste problems are:

• Upper respiratory and middle ear infections
• Radiation therapy for cancers of the head and neck
• Exposure to certain chemicals, such as insecticides and some medications, including some common antibiotics and antihistamines
• Head injury
• Some surgeries to the ear, nose, and throat (such as middle ear surgery) or extraction of the third molar (wisdom tooth)
• Poor oral hygiene and dental problems. 

Diagnosis by an otolaryngologist is important to identify and treat the underlying cause of your disorder. If a certain medication is the cause, stopping or changing your medicine may help eliminate the problem. (Do not stop taking your medications unless directed by your doctor, however.) Often, the correction of a general medical problem can correct the loss of taste. For example, people who lose their sense of taste because of respiratory infections or allergies may regain it when these conditions resolve. Occasionally, a person may recover his or her sense of taste spontaneously. Proper oral hygiene is important to regaining and maintaining a well-functioning sense of taste. If your taste disorder can’t be successfully treated, counseling may help you adjust to your problem.

If you lose some or all of your sense of taste, here are things you can try to make your food taste better:

• Prepare foods with a variety of colors and textures.
• Use aromatic herbs and hot spices to add more flavor; however, avoid adding more sugar or salt to foods.
• If your diet permits, add small amounts of cheese, bacon bits, butter, olive oil, or toasted nuon vegetables.
• Avoid combination dishes, such as casseroles, that can hide individual flavors and dilute taste.

Taste disorders can weaken or remove an early warning system that most of us take for granted. Taste helps you detect spoiled food or liquids and, for some people, the presence of ingredients to which they are allergic.

Loss of taste can create serious health issues. A distorted sense of taste can be a risk factor for heart disease, diabetes, stroke, and other illnesses that require sticking to a specific diet. When taste is impaired, a person may change his or her eating habits. Some people may eat too little and lose weight, while others may eat too much and gain weight.

Loss of taste can cause you to add too much sugar or salt to make food taste better. This can be a problem for people with certain medical conditions, such as diabetes or high blood pressure. In severe cases, loss of taste can lead to depression.

What causes external hemorrhoids?

Recognizing the symptoms of external hemorrhoids

What are the causes of external hemorrhoids?

Schizophrenia: Meaning and definition

Schizophrenia affects approximately 1 percent of all adults, globally. Experts say schizophrenia is probably many illnesses masquerading as one.

Some research suggests that schizophrenia may be the result of faulty neuronal development in the brain of the fetus, which later in life emerges as a full-blown illness.

Individuals with schizophrenia may hear voices that are not there. Some may be convinced that others are reading their minds, controlling how they think, or plotting against them. This can distress patients severely and persistently, making them withdrawn and, at times, frantic.

Symptoms of schizophrenia

A sizable proportion of people with schizophrenia have to rely on others because they are unable to hold a job or care for themselves. Many may also resist treatment, arguing that there is nothing wrong with them.

Some patients may present clear symptoms, but on other occasions, they may seem fine until they start explaining what they are truly thinking. The effects of schizophrenia reach far beyond the patient – families, friends, and society are affected too.

Symptoms and signs of schizophrenia will vary, depending on the individual.

The symptoms are classified into four categories:

• Positive symptoms – also known as psychotic symptoms. For example, delusions and hallucinations.
• Negative symptoms – these refer to elements that are taken away from the individual. For example, absence of facial expressions or lack of motivation.
• Cognitive symptoms – these affect the person’s thought processes. They may be positive or negative symptoms, for example, poor concentration is a negative symptom.
• Emotional symptoms – these are usually negative symptoms, such as blunted emotions.

Below is a list of the major symptoms:

• Delusions – the patient displays false beliefs, which can take many forms, such as delusions of persecution, or delusions of grandeur. They may feel others are attempting to control them remotely. Or, they may think they have extraordinary powers and abilities.
• Hallucinations – hearing voices is much more common than seeing, feeling, tasting, or smelling things which are not there, however, people with schizophrenia may experience a wide range of hallucinations.
• Thought disorder – the person may jump from one subject to another for no logical reason. The speaker may be hard to follow or erratic.

Other symptoms may include:

• Lack of motivation (avolition) – the patient loses their drive. Everyday actions, such as washing and cooking, are neglected.
• Poor expression of emotions – responses to happy or sad occasions may be lacking, or inappropriate.
• Social withdrawal – when a patient with schizophrenia withdraws socially, it is often because they believe somebody is going to harm them.
• Unawareness of illness – as the hallucinations and delusions seem so real for patients, many of them may not believe they are ill. They may refuse to take medication for fear of side effects, or for fear that the medication may be poison, for example.
• Cognitive difficulties – the patient’s ability to concentrate, recall things, plan ahead, and to organize their life are affected. Communication becomes more difficult.

What are the causes schizophrenia?

Experts believe several factors are generally involved in contributing to the onset of schizophrenia.

Evidence suggests that genetic and environmental factors act together to bring about schizophrenia. The condition has an inherited element, but environmental triggers also significantly influence it.

Below is a list of the factors that are thought to contribute towards the onset of schizophrenia:

Genetic inheritance

If there is no history of schizophrenia in a family, the chances of developing it are less than 1 percent. However, that risk rises to 10 percent if a parent was diagnosed.

Chemical imbalance in the brain

Experts believe that an imbalance of dopamine, a neurotransmitter, is involved in the onset of schizophrenia. Other neurotransmitters, such as serotonin, may also be involved.

Family relationships

There is no evidence to prove or even indicate that family relationships might cause schizophrenia, however, some patients with the illness believe family tension triggers relapses.

Environmental factors

Although there is no definite proof, many suspect trauma before birth and viral infections may contribute to the development of the disease.

Stressful experiences often precede the emergence of schizophrenia. Before any acute symptoms are apparent, people with schizophrenia habitually become bad-tempered, anxious, and unfocused. This can trigger relationship problems, divorce, and unemployment.

These factors are often blamed for the onset of the disease, when really it was the other way round – the disease caused the crisis. Therefore, it is extremely difficult to know whether schizophrenia caused certain stresses or occurred as a result of them.

Drug induced schizophrenia

Marijuana and LSD are known to cause schizophrenia relapses. Additionally, for people with a predisposition to a psychotic illness such as schizophrenia, usage of cannabis may trigger the first episode.

Some researchers believe that certain prescription drugs, such as steroids and stimulants, can cause psychosis.

Schizophrenia diagnosis and tests

A schizophrenia diagnosis is reached by observing the actions of the patient. If the doctor suspects possible schizophrenia, they will need to know about the patient’s medical and psychiatric history.

Certain tests will be ordered to rule out other illnesses and conditions that may trigger schizophrenia-like symptoms, such as:

• Blood tests – in cases where drug use may be a factor a blood test may be ordered. Blood tests are also done to exclude physical causes of illness.
• Imaging studies – to rule out tumors and problems in the structure of the brain.
• Psychological evaluation – a specialist will assess the patient’s mental state by asking about thoughts, moods, hallucinations, suicidal traits, violent tendencies, or potential for violence, as well as observing their demeanor and appearance.

Schizophrenia diagnosis criteria

Patients must meet the criteria outlined in the DSM (Diagnostic and Statistical Manual of Mental Disorders). This is an American Psychiatric Association manual used by healthcare professionals to diagnose mental illnesses and conditions.

The doctor needs to exclude other possible mental health disorders, such as bipolar disorder or schizoaffective disorder.

It is also important to establish that the signs and symptoms have not been caused by, for example, a prescribed medication or substance abuse.

The patient must:

• Have at least two of the following typical symptoms:
  • delusions
  • disorganized or catatonic behavior
  • disorganized speech
  • hallucinations
  • negative symptoms that are present for much of the time during the last 4 weeks
• Experience considerable impairment in the ability to attend school, carry out their work duties, or carry out everyday tasks.
• Have symptoms that persist for 6 months or more.

Treatments :

With proper treatment, patients can lead productive lives. Treatment can help relieve many of the symptoms of schizophrenia. However, the majority of patients with the disorder have to cope with the symptoms for life.

Psychiatrists say the most effective treatment for schizophrenia patients is usually a combination of:

• medication
• psychological counseling
• self-help resources

Anti-psychosis drugs have transformed schizophrenia treatment. Thanks to them, the majority of patients are able to live in the community, rather than stay in a hospital.

The most common schizophrenia medications are:

• Risperidone (Risperdal) – less sedating than other atypical antipsychotics. Weight gain and diabetes are possible side effects, but are less likely to happen, compared with Clozapine or Olanzapine.
• Olanzapine (Zyprexa) – may also improve negative symptoms. However, the risks of serious weight gain and the development of diabetes are significant.
• Quetiapine (Seroquel) – risk of weight gain and diabetes, however, the risk is lower than Clozapine or Olanzapine.
• Ziprasidone (Geodon) – the risk of weight gain and diabetes is lower than other atypical antipsychotics. However, it might contribute to cardiac arrhythmia.
• Clozapine (Clozaril) – effective for patients who have been resistant to treatment. It is known to lower suicidal behaviors in patients with schizophrenia. The risk of weight gain and diabetes is significant.
• Haloperidol – an antipsychotic used to treat schizophrenia. It has a long-lasting effect (weeks).

The primary schizophrenia treatment is medication. Sadly, compliance (following the medication regimen) is a major problem. People with schizophrenia often come off their medication for long periods during their lives, at huge personal costs to themselves and often to those around them.

The patient must continue taking medication even when symptoms are gone. Otherwise they will come back.

The first time a person experiences schizophrenia symptoms, it can be very unpleasant. They may take a long time to recover, and that recovery can be a lonely experience. It is crucial that a person living with schizophrenia receives the full support of their family, friends, and community services when onset appears for the first time.

What Is Carcinoid Syndrome?

Carcinoid syndrome is a group of symptoms you might get if you already have a type of cancer called carcinoid tumors. It starts when the tumors release chemicals into your bloodstream. The symptoms can be similar to other illnesses, like asthma, irritable bowel syndrome, and menopause. You may have episodes when your skin suddenly gets red and warm, you have trouble breathing, or you have a rapid heartbeat, for example.

Carcinoid tumors usually grow in your stomach and intestines, but you can also get them in your lungs, pancreas, or rarely, testicles or ovaries. If you have carcinoid syndrome, it usually means that your cancer has spread to another area, most often your lungs or liver.

Although there’s no cure for carcinoid tumors, treatments can help you live longer and better. You can also take steps to relieve the symptoms of carcinoid syndrome and feel more comfortable.