Pain in the eye can be an important symptom and can't be safely ignored for long. fortunately it is an unusual complaint. itching and burning are more common. eye pain may be due to injury, infection, or an underlying disease. an important disease that can cause eye pain is glaucoma. glaucoma may slowly lead to blindness if not treated. in glaucoma, the fluid inside the eye is under abnormally high pressure, and the globe of the eye is tense, causing discomfort. vision to the sides is the first to be lost, gradually and almost imperceptibly, the field of vision narrows until the individual has "tunnel vision." in addition, a person often will see "halos" around lights. unfortunately, this sequence can occur even when there is no associated pain. eye pain is a nonspecific complaint, and question relating to the pain are often better answered under the more specific headings in this chapter. a feeling of tiredness in the eyes or some discomfort after a long period of fine work (eyestrain) is generally a minor problem and doesn't really qualify as eye pain. severe pain behind the eye may result to migraine headaches, and pain either above or below the eye may suggest sinus problems. pain in both eyes, particularly upon exposure to bright light, "photophobia," is common with many viral infection improves. more severe photophobia, particularly where only one eye is involved, may indicate inflammation of the deeper layers of the eye and requires a doctor.  

Home Treatment:
Except for eye pain associated with a viral illness or eyestrain, or minor discomfort that is more tiredness than pain, we don't recommend home treatment. in these case , resting the eyes, taking a few acetaminophen, and avoiding bright light may help. follow the chart to the discussion problems where appropriate. when symptoms persist, check them out in a routine appointment with your doctor. 

Eye Pain
Is the pain related to a sifnificant injury, or is a foreign body present?
* if yes, see a doctor
* if no, use home treatment

Is the pain an itching or burning sensation, or are the eyes runny?
* if yes, see a doctor
* if no, use home treatment

Is there any decrease in vision?
* if yes, see a doctor
* if no, use home treatment

Is the pain severe or prolonged beyond 48 hours?
* if yes, see a doctor
* if no, use home treatment

Is the pain more of a feeling of tiredness in the eyes, or are flu-like symptoms present?
* if yes, see a doctor
* if no, use home treatment

Staring at a computer screen for a long time can cause eyestrain, irritation, blurred vision, and headaches. however, several studies conclude that these problems are temporary. to make them less likely:


1. Blink often, rest your eyes with momentary glances away from the screen, and use eye drops if necessary. staring at the screen tends to reduce your blinking and thus dry out our eyes.

2. Avoid glare from the screen by using indirect lighting, repositioning the screen, or using an anti-glare filter over it.

3. Make sure your monitor produces sharp, crisp images. fuzzy screen images increase eyestrain.

4. Get special glasses for your computer work if necessary. if you wear bifocals, you may be tilting your head at an uncomfortable angle to see the screen through the lower portion of your glasses.

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Poor dental hygiene and smoking cause most cases of bad breath in adults. infections may also cause bad breath. recently it has been suggested that bad breath is occasionally due to gases absorbed from the intestine and released through the lungs. unfortunately, even if this is correct, it isn't clear what can be done about it. finally unusual problems such as abscesses of the lung or heavy worm infestations have been reported to cause bad breath, although we haven't seen these in our practices.  







Smoker's Breath  
The bad breath of smoking comes from the lungs as well as the mouth. thus, mouthwashes and breath fresheners do little to help smoker's breath. getting rid of this problem is another benefit of giving up cigarettes.

Morning Breath
Bad breath in the morning is very common in adults. flossing and regular tooth brushing should eliminate this problem.

In Children
A rare of prolonged bad breath in a child is a foreign in the nose. this is especially common in toddlers, who have inserted some small object that remains unnoticed. often, but not always, there is a white, yellowish, or bloody discharge from one nostril.

Home Treatment:
Proper dental hygiene, especially flossing, and avoiding smoking will prevent most causes of bad breath. of this doesn't eliminate the odor, a visit to the doctor or dentist may be helpful. mouthwashes that simply perfume the breath. these cover up but don't treat the underlying problem. if you smoke, bad breath is another good reason to quit.


Bad Breath
Does the person have mouth sores or a sore throat?
* if yes, take medicine for that
* if no, use home treatment

Is there a white, yellow, or bloody discharge from nostril?
* if yes, see a doctor
* if no, use home treatment

Is there a decaying tooth?
* if yes, see a doctor
* if no, use home treatment

Sore throats can be caused by viruses or bacteria. especially in the winter, breathing through the mouth can dry and irritate the throat. this type of irritation subsides quickly after the throat becomes moist again.


Sore Throat Viruses
Viral sore throat, like other viral infections, can't be treated successfully with antibiotics; they must run their course. pain relievers are often helpful. older children and adolescents may develop a viral sore throat known as infectious mononucleosis or "mono". it's also called "kissing disease" because the virus is spread through saliva. the monosore throat is often severe and lasts more than a week. the person may feel particularly weak, but complications seldom occur. resting is important. there is no antibiotic curer for this virus.


Strep Throat
Sore throats due to the streptococcal bacteria are commonly referred to as "strep throat". a strep throat should be treated with an antibiotic because of two types of complications, first, an abscess may form in the throat. this is an extremely rare complication but should suspected if a child shows great difficulty in swallowing or opening the mouth, or excessive drooling. the second and more significant type of complication occurs from one to four weeks after the throat pain disappears and takes one of two forms. one form, called acute glomerulonephritis, causes an inflammation of the kidney. it is isn't certain that antibiotics will prevent this complication. the other form is the greatest concern, is the complication of rheumatic fever, which is rare today but still a problem in some regions. rheumatic fever is a complicated disease that can result in painful, swollen joints; unusual skin rashes; and heart damage. rheumatic fever can be prevented by antibioitic treatment of a strep throat. strep throat is much less frequent in adults than in children, and rheumatic fever is very rare in adults. strep throat is unlikely if the sore throat is a minor part of  a typical cold (runny nose, stuffy ears, cough, and so on). the question of when to use antibiotics for sore throats is controversial. many doctors believe that a test for strep is the best way to determine the need for antibiotics. however, the test's accuracy has ranged from 31 to 98% in various studies. furthermore, many people are "strep carriers" they have strep in their throats, but the strep isn't causing illness. in the decision chart, the same symptoms that lead you to "call doctor today" are those that will make your doctor more likely to prescribe antibiotics.


Home Treatment:
Cold liquids, acetaminophen, aspirin, ibuprofen, and naproxen are effective for sore throat pain and fever. because recent information indicates an association between aspirin and a rare but serious problem known as reye's syndrome, children and teenagers shouldn't take aspirin or cold remedies containing it. home remedies that may help include saltwater gargles and tea with honey or lemon. time is the most important healer for pain. a vaporizer makes the waiting more comfortable for some.


Sore Throat
Is there severe difficulty in swallowing, difficulty in breathing, or excessive drooling in a young child?
* if yes, see a doctor
* if no, test for strep throat

Are any of the following condition present?
1. A temperature of 38'C or greater
2. Pus in the back of the throat
3. A red rash that feels like "sandpaper" increased redness in the skin creases, and a fever
* if yes, see a doctor
* if no, test for strep throat

Is the person's age less than 35?
* if yes, test for strep throat
* if no, use home treatment

Are the person's tonsils swollen?
* if yes, test for strep throat
* if no, use home treatment