Eyestrain

Eyestrain

Definition:

Eyestrain occurs when your eyes get tired from intense use, such as driving a car for extended periods, reading or working at a computer.

Although eyestrain can be annoying, it usually isn't serious and goes away once you rest your eyes. In some cases, signs and symptoms of eyestrain can indicate an underlying eye condition that needs treatment. Although you may not be able to change the nature of your job or all the factors that can cause eyestrain, you can take steps to reduce eyestrain.

Symptoms:

Eyestrain signs and symptoms include:

• Sore, tired, burning or itching eyes
• Watery eyes
• Dry eyes
• Blurred or double vision
• Headache
• Sore neck
• Sore back
• Shoulder pain
• Increased sensitivity to light
• Difficulty focusing

Computer use or the use of other digital electronic devices can cause many of these symptoms.

When to see a doctor
If home treatments don't work to relieve your eyestrain symptoms, see your eye doctor. See your doctor if you have ongoing symptoms that may include:

• Eye discomfort
• A noticeable change in vision
• Double vision
• Headache

Causes:

Common causes of eyestrain include:

• Extended use of a computer or digital electronic devices
• Reading for extended periods
• Other activities involving extended periods of intense focus and concentration, such as driving a vehicle
• Exposure to bright light or glare
• Straining to see in very dim light

Using a computer for long periods is one of the most common causes of eyestrain. This type of eyestrain is called computer vision syndrome. In some cases, an underlying eye problem such as eye muscle imbalance or uncorrected vision can cause or worsen computer eyestrain.


Complications:

 Eyestrain doesn't have serious or long-term consequences, but it can be disruptive and unpleasant. It can make you tired and reduce your ability to concentrate. In some cases, it may take days for all eyestrain symptoms to go away after you've taken steps to change your activities or environment or treated any underlying cause.


Treatments and drugs:

Generally, treatment for eyestrain consists of making changes in your work habits or your environment.

• In some cases, eyestrain may improve if you get treatment for another underlying eye condition.
• For some people, wearing glasses that are prescribed for specific activities, such as using a computer or reading, may help reduce eyestrain.
• Your doctor may suggest that you do regular eye exercises to help your eyes focus at different distances.

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Eye melanoma

Eye melanoma

Definition:

Melanoma is a type of cancer that develops in the cells that produce melanin — the pigment that gives your skin its color. Your eyes also have melanin-producing cells and can develop melanoma. Eye melanoma is also called ocular melanoma.

Most eye melanomas form in the part of the eye you can't see when looking in a mirror. This makes eye melanoma difficult to detect. In addition, eye melanoma typically doesn't cause early signs or symptoms.

Treatment is available for eye melanomas. Treatments for some small eye melanomas may not interfere with your vision. However, treatment for large eye melanomas typically causes some vision loss.

Symptoms:

Eye melanoma may not cause signs and symptoms. When they do occur, signs and symptoms of eye melanoma can include:

• A growing dark spot on the iris
• A sensation of flashing lights
• A change in the shape of the dark circle (pupil) at the center of your eye
• Poor or blurry vision in one eye
• Loss of peripheral vision
• Sensation of flashes and specs of dust in your vision (floaters)

When to see a doctor
Make an appointment with your doctor if you have any signs or symptoms that worry you. Sudden changes in your vision signal an emergency, so seek immediate care in those situations.


Causes:

It's not clear what causes eye melanoma, also called ocular melanoma. Doctors know that eye melanoma occurs when errors develop in the DNA of healthy eye cells. The DNA errors tell the cells to grow and multiply out of control, so the mutated cells go on living when they would normally die. The mutated cells accumulate in the eye and form an eye melanoma.

Where eye melanoma occurs
Eye melanoma most commonly develops in the cells of the uvea, the vascular layer of your eye sandwiched between the retina, the thin layer of tissue that lines the back inner wall of your eyeball, and the white of your eye (sclera). Eye melanoma can occur in the front part of the uvea (iris and ciliary body) or in the back part of the uvea (choroid layer).

Eye melanoma can also occur on the most outer layer on the front of the eye (conjunctiva), in the socket that surrounds the eyeball and on the eyelid, though these types of eye melanoma are very rare.


Complications:

Complications of eye melanoma may include:

• Increasing pressure within the eye (glaucoma). A growing eye melanoma may cause glaucoma. Signs and symptoms of glaucoma may include eye pain and redness, as well as blurry vision.
  
• Vision loss. Large eye melanomas often cause vision loss in the affected eye and can cause complications, such as retinal detachment, that also cause vision loss. Small eye melanomas can cause some vision loss if they occur in critical parts of the eye. You may have difficulty seeing in the center of your vision or on the side. Very advanced eye melanomas can cause complete vision loss.
  
• Eye melanoma that spreads beyond the eye. Eye melanoma can spread outside of the eye and to distant areas of the body, including the liver, lungs and bones. 

Treatments and drugs:

Your eye melanoma treatment options will depend on the location and size of the eye melanoma, as well as your overall health and your preferences.

Waiting to treat small eye melanomas
A small eye melanoma may not require immediate treatment. If the melanoma is small and isn't growing, you and your doctor may choose to wait and watch for signs of growth. If the melanoma grows or causes complications, you may choose to undergo treatment at that time.

Surgery
Operations used to treat eye melanoma include procedures to remove part of the eye or a procedure to remove the entire eye. Options may include:

• Surgery to remove the melanoma and a small area of healthy tissue. Surgery to remove the melanoma and a band of healthy tissue that surrounds it may be an option for treating small melanomas. What procedure you'll undergo depends on the size and location of your eye melanoma. For instance, surgery to remove a small melanoma affecting the iris is called iridectomy. Surgery to remove a melanoma in the choroid is called choroidectomy.
  
• Surgery to remove the entire eye (enucleation). Enucleation is often used for large eye tumors. It may also be used if the tumor is causing eye pain. After the eye with melanoma is removed, an implant is inserted into the same position, and the muscles controlling movement of the eye are attached to the implant, which allows the implant to move. After you've had some time to heal, an artificial eye (prosthesis) is made. The front surface of your new eye will be custom painted to match your existing eye.

Radiation therapy
Radiation therapy uses high-powered energy beams, such as protons or gamma rays, to kill cancer cells. Radiation therapy is typically used for small to medium-sized eye melanomas.

The radiation is usually delivered to the tumor by placing a radioactive plaque on your eye, directly over the tumor in a procedure called brachytherapy. The plaque is held in place with temporary stitches. The plaque looks similar to a bottle cap and contains several radioactive seeds. The plaque remains in place for four to five days before it's removed.

The radiation can also come from a machine that directs radiation, such as proton beams, to your eye (external beam radiation or teletherapy). This type of radiation therapy is often administered over several days.

Laser treatment
Treatment that uses a laser to kill the melanoma cells may be an option in certain situations. One type of laser treatment, called thermotherapy, uses an infrared laser and is sometimes used in combination with radiation therapy.

Cold treatments
Extreme cold (cryotherapy) may be used to destroy melanoma cells in some small eye melanomas, but this treatment isn't commonly used.

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Eye floaters

Eye floaters

Definition:

Eye floaters are spots in your vision. Eye floaters may look like black or gray specks, strings or cobwebs that drift about when you move your eyes.

Most eye floaters are caused by age-related changes that occur as the jelly-like substance (vitreous) inside your eyes becomes more liquid. When this happens, microscopic fibers within the vitreous tend to clump together and can cast tiny shadows on your retina, which you may see as eye floaters.

If you notice a sudden increase in the number of eye floaters, contact an eye specialist immediately — especially if you also see flashes of light or lose your peripheral vision. These can be symptoms of an emergency that requires prompt attention


Symptoms:

Symptoms of eye floaters may include:

• Spots in your vision that may look like dark specks or knobby, transparent strings of floating material
• Spots that move when you move your eyes, so when you try to look at them, they move quickly out of your visual field
• Spots that are most noticeable when you look at a plain bright background, such as a blue sky or a white wall
• Spots that eventually settle down and drift out of the line of vision

When to see a doctor
Contact an eye specialist promptly if you notice:

• Many more eye floaters than usual
• A sudden onset of new floaters
• Flashes of light
• Darkness on the sides of your vision (peripheral vision loss)

These painless symptoms could be caused by a retinal tear, with or without a retinal detachment — a sight-threatening condition that requires immediate attention.


Causes:

Eye floaters may be caused by:

• Age-related eye changes. Eye floaters most commonly occur as a result of age-related changes in the vitreous, the jelly-like substance that fills your eyeballs and helps maintain their round shape. Over time, the vitreous changes in consistency and partially liquefies — a process that causes it to shrink and pull away from the interior surface of the eyeball. As the vitreous shrinks and sags, it clumps up and gets stringy. Bits of this debris block some of the light passing through the eye, casting tiny shadows on your retina.
  
• Inflammation in the back of the eye. Posterior uveitis is inflammation in the layers of the uvea in the back of the eye. Posterior uveitis, which can cause eye floaters, may be caused by infection or inflammatory diseases, among other causes.
  
• Bleeding in the eye. Vitreous hemorrhage is bleeding into the eye's jelly-like vitreous. Bleeding in the eye can have many causes, including injury and blood vessel problems.
  
• Torn retina. Retinal tears can occur when a sagging vitreous tugs on the retina with enough force to tear it. A retinal tear may cause new floaters to appear in your vision. Without treatment, retinal tear may lead to retinal detachment — an accumulation of fluid behind the retina that causes it to separate from the back of your eye. Untreated retinal detachment can cause permanent vision loss.

Treatments and drugs:


Most eye floaters don't require treatment
In most cases, eye floaters don't require treatment. Learning to cope with your floaters may take time. Living with eye floaters may be frustrating. With time, you may find you can ignore the floaters more easily and that you notice the floaters less often.

Treatments for floaters that impair your vision
In rare cases, your eye floaters may impair your vision. Rarely, floaters may be so large or so numerous that it's difficult to go about your daily tasks. In these situations, you and your eye doctor may consider treatment for your eye floaters.
Options may include:

• Using a laser to dissolve floaters. During laser therapy, an ophthalmologist aims a special laser at the floaters in the vitreous. The laser may break up the floaters and make them less noticeable. Some people who undergo laser therapy for their floaters report improved vision, while others notice little or no difference. Risks of laser therapy include damage to your retina that can occur if the laser is pointed incorrectly. Laser surgery to treat floaters is considered experimental and isn't widely used.
•  
• Using surgery to remove the vitreous. During a vitrectomy procedure, an ophthalmologist makes a small incision in your eye and removes the gel-like vitreous. A solution is placed in the eye to help it maintain its shape. Eventually, your body makes and fills your eye with fluid that will replace the solution. Vitrectomy may not remove all the floaters in your vision, and new floaters can develop after surgery. Risks of vitrectomy include bleeding and retinal tears.

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External compression headaches

External compression headaches

Definition:

External compression headaches can occur when any head wear puts continuous pressure on your forehead or scalp.

Common culprits of external compression headaches include tight hats, helmets, headbands and goggles. These headaches are sometimes known by other names that are specific to the type of equipment causing your headache, such as "swim-goggle headache" or "football-helmet headache."
With external compression headaches, the solution is as obvious as the cause. Simply remove the head wear causing the pressure.

Symptoms:

The pain of external compression headaches is often described as constant pressure. It hurts most where the object is pressing on your head. As long as the head wear is in place, the pain may get progressively worse.

When to see a doctor
Because compression headaches go away when you remove whatever object is causing the pressure on your head, it's necessary to seek further medical attention only if your headache continues after you've removed the object.

Causes:

 External compression headaches are caused by any type of head wear that places pressure on the head — including tight hats, helmets, headbands and goggles


Treatments and drugs:

To end your headache, remove the head wear that's causing the pressure. Further treatment is rarely needed.

If you have a history of migraines, wearing certain head wear may trigger an attack that requires migraine medication for relief.

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Exercise-induced asthma

Exercise-induced asthma

Definition:

If you cough, wheeze or feel out of breath during or after exercise, it may be more than exertion causing your symptoms. You might have exercise-induced asthma. As with asthma triggered by other things, exercise-induced asthma symptoms occur when your airways tighten and produce extra mucus.

If you have exercise-induced asthma — also called exercise-induced bronchospasm (BRONG-ko-spaz-um) — physical exertion may be the only thing that triggers your symptoms. Or, exercise may be just one of several things that trigger your asthma. But having exercise-induced asthma doesn't mean you shouldn't exercise. Proper treatment of exercise-induced asthma and precautions can keep you active — whether you're strolling through the park or running a race.

Symptoms:

Exercise-induced asthma symptoms can include:

• Coughing
• Wheezing
• Shortness of breath
• Chest tightness or pain
• Fatigue during exercise
• Poor athletic performance

Exercise-induced asthma symptoms may start a few minutes after you begin exercising, and they may continue to worsen for another 10 minutes or so after you've finished a workout. It's possible to have symptoms both during and after exercise.

Feeling a little short of breath or fatigued when you work out is normal, especially if you aren't in great shape. But with exercise-induced asthma, these symptoms can be more severe.
For many people, exercise is just one of a few asthma triggers. Others can include pollen, pet dander and other airborne allergens.

When to see a doctor
See your doctor if you cough, wheeze, or have chest pain or tightness during or after exercise. Many people don't realize they have exercise-induced asthma because they think these are their body's normal responses to working out. Don't assume your symptoms are caused by being out of shape or short on endurance.

Seek immediate medical treatment if you have worsening symptoms. Severe asthma attacks can be life-threatening. Signs of an asthma attack that needs emergency treatment include:

• Shortness of breath or wheezing that is quickly getting worse
• No improvement even after using a rescue inhaler, such as an albuterol inhaler
• Shortness of breath that continues even after you've recovered from your workout

Causes:

It isn't clear exactly what causes exercise-induced asthma, and why some people get it and others don't. In susceptible individuals, symptoms may be triggered by drying or cooling of the airways during heavy breathing.
Factors that can trigger or worsen exercise-induced asthma include:

• Cold air
• Dry air
• Air pollution such as smoke or smog
• High pollen counts
• Having a respiratory infection such as a cold
• Chemicals, such as chlorine in swimming pools

There's no particular exercise you must avoid when you have exercise-induced asthma, but activities that make you breathe hard are more likely to trigger symptoms. For example, aerobic exercise, such as running or playing basketball, hockey or soccer, is more likely to trigger symptoms than is
weightlifting, golfing or moderate-paced walking. Likewise, exercising in cold weather also can increase asthma symptoms because you're breathing in a lot of cold, dry air.

But don't let that discourage you. With proper treatment, you can do intense aerobic activities — and cold-weather workouts — without asthma symptoms slowing you down.

Complications:

Asthma of any kind — including exercise-induced asthma — may cause a number of complications. Proper treatment can help you avoid them. Possible asthma complications include:

• Poor athletic performance
• Permanent narrowing of the airways (bronchial tubes), which causes difficulty breathing
• Emergency room visits and hospitalizations for severe asthma attacks

Treatments and drugs:

For many people, a few puffs from a quick-relief inhaler right before exercise is enough to control asthma symptoms. These bronchodilator (brong-koh-DIE-lay-tur) medications — albuterol, for example — quickly open the airways and can help control symptoms for several hours.

Quick-relief medications
Also called rescue medications, quick-relief medications are used as needed for rapid, short-term symptom relief during an asthma attack — or before exercise if your doctor recommends it. Types of quick-relief medications include:

• Short-acting beta agonists. These inhaled bronchodilator medications include albuterol (ProAir HFA, Ventolin HFA, others), levalbuterol (Xopenex HFA) and pirbuterol (Maxair Autohaler). For most people, one to two puffs of albuterol or another inhaled short-acting beta agonist 10 to 15 minutes before exercise is enough to prevent symptoms for up to four hours. These inhaled bronchodilator medications can rapidly ease symptoms during an asthma attack. However, it is possible to develop a tolerance to these medications if they're used frequently.
  
• Ipratropium (Atrovent). Your doctor might prescribe this inhaled medication for immediate relief of your symptoms. Like other bronchodilators, ipratropium relaxes the airways, making it easier to breathe. Ipratropium is mostly used for emphysema and chronic bronchitis, but it's sometimes used to treat asthma attacks.

However, some people also need to take additional medications to control asthma symptoms. You may need daily long-term control medications if you have frequent asthma symptoms when you're not exercising, or if using a medication before exercise doesn't keep your symptoms under control.

Long-term control medications
In most cases, these medications need to be taken every day. Types of long-term control medications include:

• Inhaled corticosteroids. These medications include fluticasone (Flovent Diskus, Flovent HFA), budesonide (Pulmicort Flexhaler), mometasone (Asmanex Twisthaler), triamcinolone (Azmacort), flunisolide (Aerobid), beclomethasone (Qvar) and others. They are the most commonly prescribed type of long-term asthma medication. You may need to use these medications for several days to weeks before they reach their maximum benefit. Unlike oral corticosteroids, these corticosteroid medications have a relatively low risk of side effects and are generally safe for long-term use.
  
• Leukotriene modifiers. These oral medications include montelukast (Singulair), zafirlukast (Accolate) and zileuton (Zyflo, Zyflo CR). They help prevent asthma symptoms for up to 24 hours. In rare cases, these medications have been linked to psychological reactions, such as agitation, aggression, hallucinations, depression and suicidal thinking. Seek medical advice right away for any unusual reaction.
  
• Theophylline. This is a daily pill that helps keep the airways open (bronchodilator). Theophylline (Theo-24, Elixophyllin, others) relaxes the muscles around the airways to make breathing easier. It's not used as often now as in past years because more-effective medications are available.
  
• Long-acting beta agonists (LABAs). These inhaled medications include salmeterol (Serevent Diskus) and formoterol (Foradil Aerolizer). Taken 30 minutes before exercise, long-acting beta agonists can prevent symptoms of exercise-induced asthma for up to 12 hours. However, they've been linked to severe asthma attacks. LABAs should always be taken only in combination with an inhaled corticosteroid.
  
• Combination inhalers. Fluticasone and salmeterol (Advair Diskus), budesonide and formoterol (Symbicort), and mometasone and formoterol (Dulera) are examples of combination inhalers. These medications contain a LABA along with a corticosteroid. Like other LABA medications, these medications may increase your risk of a severe asthma attack and need to be used with caution.

Treatment for allergy-induced asthma
If your asthma is triggered or worsened by allergies, you may benefit from allergy treatment as well. Allergy treatments include:

• Omalizumab (Xolair). This medication is specifically for people who have allergies and asthma. It reduces the immune system's reaction to allergy-causing substances, such as pollen, dust mites or pet dander. Xolair is delivered by injection.
  
• Allergy medications. These include oral and nasal spray antihistamines and decongestants as well as corticosteroid, cromolyn and ipratropium nasal sprays.
  
• Allergy shots (immunotherapy). Over time, immunotherapy injections gradually reduce your immune system reaction to specific allergens. This may help relieve your symptoms if certain allergens, such as pollen, trigger your asthma.

Don't rely only on quick-relief medications
If you've been prescribed long-term asthma control medications — such as inhaled corticosteroids — you shouldn't need to use your quick-relief inhaler more often than your doctor recommends. Keep a record of how many puffs you use each week. If you frequently need to use your quick-relief inhaler, see your doctor. You probably need to adjust your long-term control medication.

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Exercise headaches

Exercise headaches

Definition  :

Exercise headaches occur during or after sustained, strenuous exercise. Activities associated with exercise headaches include running, rowing, tennis, swimming and weightlifting.

Doctors divide exercise headaches into two categories. Primary exercise headaches are usually harmless, aren't connected to any underlying problems and can often be prevented with medication. Secondary exercise headaches, on the other hand, are caused by an underlying, often serious, problem within the brain — such as bleeding or a tumor — or outside the brain — such as coronary artery disease. Secondary exercise headaches may require emergency medical attention.

Symptoms:

Primary exercise headaches
These headaches:

• Are usually described as throbbing
• Occur during or after strenuous exercise
• Affect both sides of the head in most cases

Secondary exercise headaches
These headaches may cause:

• The same symptoms as primary exercise headaches
• Vomiting
• Loss of consciousness
• Double vision
• Neck rigidity

Primary exercise headaches typically last between five minutes and 48 hours, while secondary exercise headaches usually last at least a day and sometimes linger for several days or longer.
When to see a doctor
If you experience a headache during or after exercise, consult your doctor. Call your doctor right away if the headache begins abruptly or if it's your first headache of this type.

Causes:

Primary exercise headaches
The exact cause of primary exercise headaches is unknown. One theory is that strenuous exercise dilates blood vessels inside the skull.
Secondary exercise headaches
Secondary exercise headaches are caused by an underlying problem, such as:

• Bleeding in the area between the brain and the thin membranes that cover the brain (subarachnoid hemorrhage)
• Abnormalities in a blood vessel leading to or within the brain
• Cancerous or noncancerous tumors
• Obstruction of cerebrospinal fluid flow
• Reduced blood flow in the arteries feeding the heart
• Sinus infection

Treatments and drugs:

If no underlying structural or vascular problem is causing your exercise headaches, your doctor may recommend medications to take regularly to help prevent the headaches.

• Indomethacin (Indocin), an anti-inflammatory drug, is commonly prescribed.
• Propranolol, (Inderal, Inopran XL) a blood pressure medication, also is used to preventive exercise headaches.

If your exercise headaches are predictable, you may be able to take a medication an hour or two before a scheduled event, such as a tennis match or a hike at high altitude. Medications your doctor might prescribe include indomethacin and triptans (Imitrex, Relpax, others), which are commonly used to treat acute migraine headaches. If your exercise headaches are frequent or unpredictable, you might need to take the preventive medicine every day.

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Essential tremor

Essential tremor

Definition  :

Essential tremor is a disorder of the nervous system that causes a rhythmic shaking. Essential tremor can affect almost any part of your body, but the trembling occurs most often in your hands — especially when you try to do simple tasks, such as drinking from a glass, tying shoelaces, writing or shaving. Essential tremor also may affect your head, voice, arms or legs.

Although usually not a dangerous condition, essential tremor worsens over time and can be severe in some people. It isn't caused by other diseases, although it's sometimes confused with Parkinson's disease. Essential tremor can occur at any age but is most common in older adults.

Symptoms:

Essential tremor signs and symptoms:

• Begin gradually
• Worsen with movement
• Usually occur in the hands first, affecting one hand or both hands
• Can include a "yes-yes" or "no-no" motion of the head
• Are aggravated by emotional stress, fatigue, caffeine or extremes of temperature

Essential tremor vs. Parkinson's disease
Many people associate tremors with Parkinson's disease, but the two conditions differ in key ways:

• When tremors occur. Essential tremor of the hands typically occurs when you use your hands. Tremors from Parkinson's are most prominent when your hands are at your sides or resting in your lap.
  
• Associated conditions. Essential tremor doesn't cause other health problems, whereas Parkinson's is associated with a stooped posture, slow movement and a shuffling gait. However, people with essential tremor may sometimes develop other neurological signs and symptoms — such as an unsteady gait (ataxia).
  
• Parts of body affected. Essential tremor can involve your hands, head, voice and legs. Tremors from Parkinson's typically affect your hands but not your head or voice.

Causes:

 About half of essential tremor cases appear to occur because of a genetic mutation. This is referred to as familial tremor. What causes essential tremor in people without a known genetic mutation isn't clear.

Complications:

Essential tremor is not life-threatening, but symptoms often worsen over time. If the tremors become severe, you may find it difficult to:

• Hold a cup or glass without spilling
• Eat normally
• Put on makeup or shave
• Talk, if your voice box or tongue is affected
• Write — handwriting may become increasingly large, shaky and illegible

Treatments and drugs:

Some people with essential tremor may not require treatment if their symptoms are mild. But if your essential tremor is making it difficult to work or perform daily activities, you may want to discuss treatment options with your doctor.
Medications

• Beta blockers. Normally used to treat high blood pressure, beta blockers — such as propranolol (Inderal), atenolol, metoprolol and nadolol — help relieve tremors in some people. They may not be an option if you also have asthma, diabetes or certain heart problems.
  
• Anti-seizure medications. Epilepsy drugs — including primidone (Mysoline), gabapentin (Neurontin) and topiramate (Topamax) — may be effective in people who don't respond to beta blockers. The main side effects are drowsiness and flu-like symptoms, which usually disappear within a short time.
  
• Tranquilizers. Doctors sometimes use drugs such as diazepam (Valium) and alprazolam (Xanax) to treat people whose tremors are made much worse by tension or anxiety. Side effects can include confusion and memory loss. Additionally, these medications should be used with caution because they can be habit-forming.
  
• OnabotulinumtoxinA (Botox) injections. You're probably familiar with Botox as a treatment for facial wrinkles, but it can also be useful in treating some types of tremors, especially of the head and voice. Botox injections can improve problems for up to three months at a time. But if it's used to treat hand tremors, it can sometimes cause weakness in your fingers.

Therapy
Physical therapy exercises can sometimes reduce tremor and improve coordination and muscle control. Occupational therapists may suggest some of the following adaptive devices to reduce the effect of your tremors on your daily activities:

• Heavier plates, glasses and utensils
• Wrist weights
• Wider writing implements

Surgery
Surgery may be an option for people whose tremors are severely disabling and who don't respond to medications. The type of surgery performed is known as deep brain stimulation.

Deep brain stimulation involves inserting a long, thin electrical probe into your thalamus — the portion of your brain responsible for causing your tremors. A wire from the probe is tunneled under your skin to your chest, where a pacemaker-like device has been inserted. This device transmits painless electrical pulses to interrupt signals from your thalamus that may be causing your tremors.

Side effects of surgery may include problems with motor control or speech, problems with balance and temporary or permanent cognitive impairment, such as learning difficulties, or problems with your vision. Deep brain stimulation, however, is very effective for severe essential tremor, and these side effects are rare.

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