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Your Good Health: Pinguecula doesn’t affect vision

Dear Dr. Roach: I am under the care of an ophthalmologist, and on a routine exam I was told that I have pinguecula of the eyes. What does this mean? I was given artificial tears and am to follow up regularly.
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Dr. Keith Roach writes a medical question-and-answer column weekdays.

dr_keith_roach_with_bkg.jpgDear Dr. Roach: I am under the care of an ophthalmologist, and on a routine exam I was told that I have pinguecula of the eyes.

What does this mean? I was given artificial tears and am to follow up regularly. The eye doctor is going to reevaluate in three months. I am very worried.

V.P.

A pinguecula is a benign lesion made of fat and protein. It’s located in the conjunctiva of the eye, at the limbus — the point where the sclera (the white of the eye) meets the cornea (the clear part that is on top of the iris and lens).

A pinguecula never goes over onto the cornea, which distinguishes it from another common eye lesion, a pterygium.

We think they are caused by years of irritation from dust, wind and sun exposure. You need not be worried, because a pinguecula doesn’t affect vision and usually doesn’t need treatment beyond lubricating eyedrops.

Dear Dr. Roach: Several years ago, a friend gave me a recipe to lower blood sugar. He said his mother used it, and it helped her.

I want to know if it is for real or an old folk remedy that was passed through the generations. You mix apple cider vinegar with apple and grape juices, and drink 2 oz in the morning and 2 oz in the evening.

I made a batch but halved it because it seemed like a lot to start. My blood sugar dropped seven points since I started taking it two days ago.

Can you tell me if this is a real thing or a temporary situation until I see my doctor next week? Does something like this really work? Or was my sugar just going down naturally?

R.C.

Some old folk remedies do work, and it has taken years for scientists to try to find out which ones are really useful and, if so, why.

In the case of apple cider vinegar, there is a small study showing that 20 grams of apple cider vinegar (about 4 tsp) did lower blood sugar when volunteers with diabetes were given a meal of a bagel with butter and orange juice. The magnitude of the effect is small — usually not enough to be an effective treatment by itself. I also am concerned about the effect of vinegar on the teeth.

Adding fruit juice to the vinegar doesn’t seem to be necessary (fruit juice wasn’t used in the study) and it adds sugar, which is generally not a good idea in people with diabetes.

Dear Dr. Roach: I am a 69-year-old man in good health. At night I fall asleep quickly, but wake up several times during the night. Sometimes I am awake for up to two hours.

If I take a 1.5 mg gummy of melatonin, I sleep soundly and go back to sleep quickly if I do wake up. Is there any reason to be concerned about the frequent use of melatonin?

C.S.

Melatonin is a commonly used sleep aid that is generally considered safe. At the low dose you are taking, it is unlikely to have significant adverse effects. However, some other sleep aids can increase risk for falls or motor vehicle accidents. Unfortunately, it doesn’t work for everyone, but if it is working for you, it seems to be pretty safe.

Studies have shown that 1-3 mg is (surprisingly) more effective than higher doses.

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 ToYourGoodHealth@med.cornell.edu