Dear Dr. Roach: I鈥檝e heard of people using hydrogen peroxide (three per cent) as an emetic. How dangerous is this practice, and is it effective?
B.G.
Hydrogen peroxide taken internally is neither safe nor effective for any medical indication. An emetic is a substance that makes people vomit, and they are seldom if ever used in clinical practice. Syrup of ipecac, which is still in many homes, is no longer recommended by expert pediatric and toxicology groups.
Using an emetic is especially dangerous in a case involving caustic ingestions (such as lye) 鈥� the esophagus is exposed to the dangerous swallowed material a second time. For most toxic ingestions, emergency rooms provide activated charcoal, which adsorbs (binds) the toxin, which is then eliminated and not absorbed.
Ipecac is no longer available and should be discarded. Instead of an emetic, call the poison-control hotline for advice on a suspected ingestion. The sa国际传媒 Poison Control Centre is at 1-800-567-8911.
Dear Dr. Roach: I am 66 years old and only recently have needed glasses for distance, but have needed drugstore readers for close-up vision for about 20 years. I went to my eye doctor last fall, and he gave me long-distance glasses, which are working great, and insisted that I get prescription readers, which also are great.
I was reading my e-reader the other night with prescription readers on, and had trouble focusing. I closed my right eye, which is usually dominant, and saw a spot right in the middle of my vision.
I tried closing my left eye to see if that was the problem, then tried the right eye again. The spot was still there, and it鈥檚 been there for days. It doesn鈥檛 seem to interfere with my distance vision, just close. The spot is faint yet obvious, and it鈥檚 directly in the middle of my right eye 鈥� sometimes blue, sometimes green, but always circular.
Can you give me any information about this? I will call my optometrist soon, but I鈥檇 like your input.
E.P.
While we all have a blind spot in our vision, we are not normally aware of it, because the brain fills in the information from the other eye.
The blind spot in each eye is a fair distance to the outside of the centre of vision, and represents the optic nerve, where there are no light receptors on the retina. A blind spot in the centre of the vision is suspicious for macular degeneration, but it also can be caused by a retinal detachment or other causes.
You can test the centre vision with an Amsler grid, one of which can be found and used on the computer or printed out, at www.amd.org/the-amsler-grid. Abnormalities should be reported immediately to your eye professional.
For some conditions, such as a retinal tear, treatment is much more effective if it is begun promptly (within hours).
Macular degeneration isn鈥檛 as much of an emergency, but early treatment is much better than waiting. Any persistent loss of vision should be treated seriously and evaluated promptly.
Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to [email protected].
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