Dear Doctors: Is it OK to go without shoes? I’ve heard conflicting information. I wear supportive shoes for exercise and in public, but I prefer bare feet at home. I stand about six hours a day, and I just find it much more comfortable without shoes. I am 65 and healthy, with no history of foot problems.

Dear Reader: It’s not surprising that you have run into different advice about going barefoot. While opinions on the subject tend to be based on health concerns and issues of hygiene, they can also sometimes be due to cultural views and norms. That said, there is no universal guidance on the practice. The answer is based on each person’s health and well-being. Nonmedical factors such as climate, the surfaces on which the person is standing or walking, and their daily activity levels also play a key role.

For most healthy people, going barefoot indoors does not pose a health risk. In fact, proponents say that spending time without shoes on can add strength and flexibility in the feet and ankles, improve circulation and help with posture. When people are free from footwear, they often become more aware of the countless muscular microadjustments we make to stay balanced as we move and stand. And as you point out in your letter, for many people, going barefoot just feels good.

That said, there are a few important points to keep in mind. There are situations where extended time barefoot is not advisable, like with structural problems in the feet or ankles. Examples include flat feet, fallen arches, bunions, plantar fasciitis, arthritis, fat pad loss or a tight Achilles tendon. People living with diabetes must also be careful about going barefoot. The disease can impair circulation, particularly in the feet. Even a slight scratch or cut can quickly escalate into a more serious health concern.

Going barefoot can also be a health risk for people living with neuropathy. This can also apply to people with poor circulation not related to diabetes. It’s inadvisable for people with a history of foot ulcers or balance problems that raise the risk of a falling. Those living with health conditions or undergoing medical treatments that weaken the immune system may need to take caution.

When going barefoot, you need to think about safety. Wood, tile, stone and laminate floors can each have rough, jagged or uneven surfaces that can cause a wound. Carpet is forgiving, but it can camouflage hidden dangers such as a tack, nail or shard of broken glass. Cleanliness is also an issue. Bacteria, dirt, dust and other germs continually migrate indoors with human and pet traffic. Some fungi, including the one that causes athlete's foot, are contagious and can be transmitted on shared flooring. Choosing to go barefoot also adds a daily task: washing your feet to keep things hygienic.

You have shared that you are in good health, don’t have problems with your feet and keep going barefoot a strictly indoor activity. In this scenario, you meet the criteria for safely ditching your footwear for a few hours a day.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: You recently stated in a column about eye floaters that there is no cure at this time. I got a vitrectomy for this condition, and it was life-changing for me. By no means is this procedure meant for everyone as it is not without risk, but there is a cure!

Dear Reader: Eye floaters are so common, an explanation of the term may not be necessary. About 70% of adults have them to some degree. For those lucky enough to not know what we’re talking about, we’ll explain: Floaters are tiny clumps of collagen, protein and other cellular debris that drift through the vitreous. The vitreous is the gel-like substance that fills the back of the eye. Because these particles block the path of light entering the front of the eye, they cast shadows on the retina that can appear as specks, strands or cobweblike shapes.

In most cases, floaters aren’t a risk to eye health. For some people, they can be severe enough to interfere with vision. Extensive floaters can make it hard or even impossible to engage in daily activities such as reading, working at the computer or driving. They can also interfere with visual clarity in low light and adversely affect night vision. When floaters become severe and persistent, doctors may recommend the surgery you had.

A vitrectomy is surgery to remove the vitreous from the eye. The doctor makes small cuts, then suctions out the vitreous. Because the vitreous helps maintain the shape and volume of the eyeball and holds the retina in place, they then replace it. In most cases, they replace it with a sterile saline solution. If there are other retinal issues, they may use a bubble of air or gas or silicone oil.

This is usually an outpatient surgery, and you return home the same day. Side effects can include redness, swelling and a few days of blurred vision. Patients use a temporary eye patch and eyedrops to reduce swelling and prevent infection during recovery. Patients must restrict their driving during the initial recovery period. It is also important to avoid physical exertion for a few weeks. If the eye is refilled with a gas bubble, patients may need to keep their head in a downward position to keep the bubble pressed against the retina. Patients must also avoid high altitudes or flying until cleared by their doctor.

As you note in your letter, this surgery isn’t for everyone. Risks include bleeding, infection, retinal detachment, glaucoma, cataract formation and possible changes to vision. As a result, vitrectomy is often reserved for severe cases where floaters are severely impacting quality of life. Someone with severe floaters should begin by seeing an ophthalmologist who specializes in this condition. They will assess your situation and help you to understand the risks and benefits, other treatment options and what to expect if you proceed. We are happy to know that your own surgery went well and that it resolved the visual problems you had.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)

Kansas City, MO 64106; 816-581-7500

Hello, dear readers! Welcome to our monthly letters column. We've had some interesting mail, so we'll get right to it.

-- Our columns often touch on the benefits of regular exercise on body, mind and mood. We heard from a reader who finds that, in some workout classes, pursuing those rewards may be putting your hearing at risk. "Various health clubs and rec centers where I've attended spin classes really crank up the music," he wrote. "The decibel levels sound off the charts. With the loud, sustained music and blasting instructions lasting 50 minutes or more, what risks to hearing do the students face?" Your concerns are valid. Hearing damage depends not only on volume, but on duration as well. Sustained sound levels above 85 decibels can harm hearing. Spin classes can hit 90 or even 100 decibels -- over the recommended safe exposure limits -- in a matter of minutes, not hours. At those levels, repeat exposure can lead to ringing in the ears, increased sound sensitivity over time and possibly even permanent hearing loss. Ear plugs would be a good idea.

-- Another important topic we’ve covered is getting the most out of a medical appointment. A reader wrote to share a practical tip. "When at a doctor's appointment, I often ask if I can record the findings on voice memos on my phone," he wrote. "That way I can replay the discussion, share with my wife and google anything I didn't quite understand. It is also a good record, for me, of my past issues." Each step of the way, you’re making good choices. That begins with making sure the practitioner is comfortable with recording. The recording itself can be a useful tool for all the reasons you outlined. A medical setting can be stressful. When information about your health is complex or emotionally charged, it’s easy to feel overwhelmed. An audio record allows repeated access to that information, giving you time to process it, research it and come up with follow-up questions that can lead to improved outcomes.

-- A recent column about potassium, an important nutrient, prompted this suggestion from a reader: "I appreciate your focus on dietary solutions to increase potassium intake, but you forget an additional source: low-sodium salt. It's a combination of sodium chloride, with added potassium chloride," he wrote. "It cuts sodium intake in half while providing 350 mg of potassium. Of course, those whose potassium intake should be limited due to a medical condition should steer clear." Yes, low-sodium salt can be a good source of potassium for people with normal kidney function. And for anyone with kidney disease, heart failure, diabetes or adrenal disorders, or taking medications that raise potassium levels, it can pose a health risk. It's a good idea to check with your doctor if switching is right for you.

Thank you, as always, to everyone who to took the time to write. You are keeping our inboxes full, so we will be back with a bonus letters column next week.

(Send your questions to askthedoctors@mednet.ucla.edu, or write: Ask the Doctors, c/o UCLA Health Sciences Media Relations, 10960 Wilshire Blvd., Suite 1955, Los Angeles, CA, 90024. Owing to the volume of mail, personal replies cannot be provided.)