Dr Fred Kavalier: A Question of Health

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I have been having trouble with my eyes and, after seeing several specialists, I was diagnosed with Stargardt's disease, which will probably get worse. What is the cause of this? Are there any treatments?

I have been having trouble with my eyes and, after seeing several specialists, I was diagnosed with Stargardt's disease, which will probably get worse. What is the cause of this? Are there any treatments?

Stargardt's disease is an inherited form of macular degeneration that affects young people. Macular degeneration is a common cause of visual problems in elderly people, but it is unusual before the age of 60. In macular degeneration, the cells that detect light in the centre of the retina (the macula) stop functioning and die. It does not usually progress to complete blindness, but loss of the centre of the retina seriously impairs the ability to do everyday things such as reading and driving. No proven treatment for Stargardt's disease has yet been developed. Stargardt's disease is inherited from both parents. It is a recessive genetic condition, which means that each parent is a healthy carrier of the gene that causes the disease. The chance of two gene carriers having a child who is affected by the disease is one in four. Find out more about all forms of macular degeneration from the RNIB Helpline (0845 766 9999) or website ( www.rnib.org.uk).

I have started getting a burning pain in the ball of the foot when I walk more than a few hundred yards. Sometimes, one or two of the middle toes feel numb. When I rest, the pain and numbness go away but always returns if I start walking again. Any ideas?

You may have developed a Morton's neuroma, which is a thickening of the tissues that surround the nerves of the foot. The neuroma usually develops in between the second, third or fourth toes. It is made worse by tight-fitting shoes and raised heels, which put pressure on the front of the foot. Sometimes there is an area of great tenderness between long bones of the foot that lead to the toes. You should see a good podiatrist, who may be able to help things with advice about footwear. A steroid injection can help this condition, but the final solution is an operation.

Please send your questions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax 020-7005 2182 or e-mail to health@independent.co.uk. Dr Kavalier regrets that he is unable to respond personally to questions

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