Store glasses will help you read tiny type, won't hurt the eyes

MEDICAL MATTERS

Staying healthy

November 25, 2005|By JUDY FOREMAN

Are the eyeglasses you buy in a drugstore as good as prescription ones?

In many cases, yes, especially if your main problem is presbyopia, the age-related decline in the ability to see small print up close because the eyes lose their ability to change shape and focus at different distances.

As you approach 40, this focusing ability deteriorates, and while distance vision often remains good, close vision does not.

"Presbyopia happens to everyone," said Dr. Elliott Myrowitz, an optometrist and assistant professor of ophthalmology at the Wilmer Eye Institute at Johns Hopkins School of Medicine.

Store-bought glasses are fine for presbyopia if your eyes are equal and healthy, said Dr. Bonnie Henderson, director of the comprehensive ophthalmology service at the Massachusetts Eye and Ear Institute. But because the store-bought lenses are equal in magnification, they may not help as much if one eye is stronger than the other.

Nor do they help if you have astigmatism, in which the cornea (the clear dome in the front of the eye) is abnormally shaped. That needs to be corrected with a prescription.

Store-bought glasses can sometimes help compensate for mild vision problems, either up close or far away.

Since drugstore glasses are cheap - $15 or so - it makes sense to try these first before handing over at least $100 for prescription glasses.

Get your eyes checked every year or so anyway, especially after age 40, to make sure you don't have glaucoma or problems with your retinas. You should also consider switching to prescription glasses if your drugstore lenses cause eye fatigue, headaches, excessive blinking or problems refocusing between close-up and far-away tasks.

Neither store-bought nor prescription glasses weaken or damage your eyes, so use them as often as you need to.

Is it normal for an adult to occasionally wet the bed?

Although bedwetting is fairly common in children, who usually grow out of it, it's much less common in adults.

Doctors from the Mayo Clinic estimated in a paper published nine years ago that 1.5 to 3 percent of the adult population had "persistent nocturnal enuresis," meaning chronic nighttime bedwetting.

An adult who wets the bed only occasionally and has no other voiding problems is unlikely to have anything seriously wrong with the urinary tract, said Dr. Dianne Sacco, a urologist at Massachusetts General Hospital. Occasional bedwetting often occurs at a time of excessive emotional stress, she added. If the problem becomes persistent or the person also has voiding problems during the day, it's wise to see a doctor.

The potential causes of bedwetting, in kids and adults, are many. Some researchers think it's a psychological problem. Others note that bedwetting runs in families, suggesting a genetic trigger.

Still others believe it's caused by sleeping too deeply, especially in children, or by reduced bladder capacity or urinary tract infections.

Other possible causes include neurological abnormalities (in which nerves to the bladder fire too often) or a decrease in the secretion of so-called anti-diuretic hormone, which regulates the amount of urine made.

In older adults, other conditions may also trigger bedwetting, including congestive heart failure and sleep apnea.

The sleep disorder hypothesis is particularly controversial. Shelly Morris, a former adult bedwetter who now runs the Enuresis Treatment Center of America in Cape Coral, Fla., believes that some people sleep so deeply they can't wake up to urinate. Her program uses moisture alarms that wake the sleeper (or family members) at the first drop of urine - in time to get to the bathroom.

But Dr. John Winkelman, medical director of the Sleep Health Center at Brigham and Women's Hospital in Boston, said he doubted that deep sleep is a common cause of adult bedwetting, except when it's the result of medications. "Excessively deep sleep is unusual for adults. Adults usually have excessively light sleep," he said.

If you have a bedwetting problem, try training yourself to wake up with a bedwetting alarm, available on the Web. You can also try drugs such as Tofranil, DDAVP or Ditropan, Detrol, Vesicare, Sanctura or Enablex. But bedwetting may recur if the drugs are stopped.

Send your questions to foreman@baltsun.com.

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