Had uppers cauterized... my experience

[Guest]

I'm posting this in case someone comes along who wants to know what it feels like getting this done etc.

So... here is what they do (or did for me anyways!) - I had it done yesterday afternoon.

First, they put some numbing drops in your eyes... wait for that to kick in a bit, then put in some numbing gel. This doesn't hurt, but it feels really weird when you try to blink with your eyeballs and lids numbed like that.

After THAT kicks in, they inject the lid area near the puncta with local anesthetic. They wait for THAT to kick in, and then inject a bit more local anesthetic. If you've ever had local anesthetic injected in the past (for example, before getting a bad cut stitched up etc), you'll know it burns like MAD when they inject this stuff. Luckily, because of the numbing drops/gel, when they injected it into my lid, all I felt was a pin prick... a bit uncomfortable, but really not too bad at all.

Now for the cautery...

My right lid seems to have taken to the anesthetic better, so I barely felt a thing when they cauterized it... I felt a tiny bit of warmth, but that's it. When he was finished, I noticed a little bit of smoke wafting upwards.

For my left lid, I definitely felt it more... I felt more heat that time... it actually hurt a bit. But it wasn't that bad, and was over in a second.

Afterwards, my vision was blurred due to the anesthetic gel and all the tearing that my eyes were doing. My lids still felt really weird because they were so numb - I was glad to have my husband there to drive us home! My vision cleared a lot in the next 1/2 hour, so I suppose if I had gone myself, I could have just waited a bit, and then drove myself home... but because my eyelids hurt where the cautery was done, it was nice to not have to drive.

So as not to freak anyone out, I only felt pain afterwards if I moved my eyes or lids... if I just kept my eyes shut, or was careful not to look around too much when they were open, I felt zero pain. And, even if I did feel pain when looking around, it wasn't horrible or anything.

My eyes watered a lot for the rest of the day... this made my eyes red, as if I'd been crying.

But, there was a nice bonus to all of this watering... I had the best sleep I've had in ages last night... and I didn't need to reapply eye drops even once overnight. When I woke up in the morning, my eyes started watering, so I didn't need to use drops to get them open. THIS was very nice! My eyes were only a very light pink... nice that they aren't red this morning...

My eyes are still watering today... I'm hoping all of this reflex tearing will calm down after a few days... but in the mean time, I'm going to enjoy the fact that my eyes aren't bone dry for once!

I have almost zero discomfort in the cauterized area today... an occasional twinge of discomfort, but it's quite minor.

Before you get cautery, they tell you that you might have a small scab where the puncta is, or a small bruise where they injected the local anesthetic. At the moment, I have no scab, but if I look under my lid, I can see a raised area where the puncta used to be... maybe a blister?? not sure... On my right eyelid, I have a tiny bruise from the injection (it's about 1/4 inch long, and 1/8 inch wide... I don't think anyone would really notice it if they looked at me though).

My doc told me to use Polysporine eye ointment for a few days afterwards to prevent infection.

For those of you who have had cautery yourselves, how long did it take for the reflex tearing to calm down?

[msienkiewicz]

I don't know; this sounds scary to me.

I'm a wimp!

I hope this brings you relief in the long run. Let us know if it helps long term.


Melissa

[gary]

Hi Saag
I had my lowers cauterized about a year ago,all she done was put some numbing agent on some large q tips and left them on the puncta for about five minutes,then she had what looks like an ink pen size instrument with a small wire sticking out the end of it. she inserted it into the duct opening and pushed the button,it kinda stung a little but I didn't see any smoke or anything but I could smell the flesh burning. As far as reflex tearing I had it for about one minute and that was it, never had any more. I did go back in about two months and she said that they had reopened and she done it again.I can't tell that it has helped me any at all,for all I know they probably have reopened again.I am not going back to her anymore to find out.

Gary

[Guest]

I don't know; this sounds scary to me.

I'm a wimp!

I hope this brings you relief in the long run. Let us know if it helps long term.


Melissa

I've been terrified of cautery myself up until recently... the very idea of it just freaked me out.

But, my eyes have been so awful, that I became more scared of living like THAT forever, than I was scared of getting cauterized. I mean after Restasis, lower plugs, tetracycline, warm compresses, cold compresses, fish oil, tranquileyes, etc etc. and STILL wearing goggles almost all the time, I just had to try cautery. Fortunately, my cautery procedure wasn't too bad in the end... so I'm glad I did it (so far, anyways!).

Thanks for the good wishes! Wow, would it ever be awesome to have some long-term relief now!

[Guest]

Hi Saag
I had my lowers cauterized about a year ago,all she done was put some numbing agent on some large q tips and left them on the puncta for about five minutes,then she had what looks like an ink pen size instrument with a small wire sticking out the end of it. she inserted it into the duct opening and pushed the button,it kinda stung a little but I didn't see any smoke or anything but I could smell the flesh burning. As far as reflex tearing I had it for about one minute and that was it, never had any more. I did go back in about two months and she said that they had reopened and she done it again.I can't tell that it has helped me any at all,for all I know they probably have reopened again.I am not going back to her anymore to find out.

Gary

That's too bad that yours re-opened like that... have you asked another doctor for a second opinion? Maybe someone else would do a better job of it??

I'm glad to hear that your reflex tearing didn't last long... maybe that means that what I have now is here to stay then!

[Guest]

I've had the best eye-day today that I've ever had since LASIK. I haven't needed to use any artificial tears, and my eyes feel AWESOME!!!! (well, not pre-lasik awesome, but definitely awesome compared to pre-cautery)

Oh, and better yet, I put away my goggles today!!! I look like ME again!!! /sigh... I sure hope this good feeling lasts... in any case, I plan on enjoying every minute of it for as long as I have it!

The only time I have felt any discomfort is when doing something that I accidentally concentrate on (and therefore presumable don't blink as much)... my eyes burn the tiniest bit then. But they only burn a tiny bit... that's fabulous compared to what I've had to deal with before cautery. And, better still, the tiny bit of burning goes away within 2 or 3 blinks.

My eyes feel very wet, and I've been dabbing at them with kleenex to soak up the tears periodically, but I don't care... I will happily live with this forever... it is SO much better than being bone dry. oooooo.... I sure hope these tears are permanent, and not just reflex tears from the cautery procedure itself...

I still blink a million times a minute too... if I don't, my eyes burn... wierd... you'd think with all this wetness I wouldn't need to do that so much... but I assume it must be because my meibomian glands are still a bit messed up?


Anyhow, I'll give more updates as time goes on... we'll see if these eyes of mine stay wet or not...

[gary]

yes Saag,I have asked one ophthalmolgist,and an optometrist both just shrugged their shoulders and said its really hard to tell,then went on to what they wanted to say.Its kinda like Lucy said about trying to get them to express your glands,they don't want to.

It sounds like that if your meibomain glands were doing their job properly you would be 100 percent better.

When I look into the mirror my eyes look moist,I just think that my tbut is very low . I sure hope that Rhads experiment with that aspect is a sure thing.

I am considering IPL with Dr. Toyos in Memphis,which is only about 180 miles from me.I wished I knew which method would be the most beneficial,IPL or probing. The IPL sounds like that it would be the least painful though.

I am glad that you are better,and that you continue to improve.
Gary

[Guest]

Well, I woke up this morning with zero foreign body sensation, and my lids feel back to normal... but as I feared, my tears are gone too. It looks like that wetness was all reflex tearing after all... what a bummer.

Better get my goggles back out. Man... this really sucks. It'll be interesting to see how my eyes feel as the day goes on... maybe this zero tears thing is just a morning thing .. I can dream, can't I?

[willwork4tears]

yes Saag,I have asked one ophthalmolgist,and an optometrist both just shrugged their shoulders and said its really hard to tell,then went on to what they wanted to say.Its kinda like Lucy said about trying to get them to express your glands,they don't want to.

Gary

I have had major problems finding a good rheumatologist (the problem is, I still haven't). So I feel your pain.

But I have to say my opthalmologist is much more responsive to my needs. I saw him on Monday and asked about my Meibomian glands. He said "I'd be happy to check them for you." He said he would express them if I needed it. After examining them he said they didn't need to be expressed because "my oil flowed nicely" but described how to do it at home in case I was interested in trying it anyway. I haven't met any resistance with my eye Dr. on any treatment, so evidently I am on of the very lucky ones. My advice is to find a new Dr. My eye doctor is a corneal specialist, so maybe that helps - he's used to working with patients like me.

[Guest]

Ok... so I'm feeling reeeeeally sheepish now. I panicked a bit when I woke up this morning and the tears didn't start flowing right away like they did yesterday

But since I've been up and moving around, the tears came back! Whew... I am so incredibly relieved. I am now putting my goggles away again

[willwork4tears]

Since your doctor told you the oil is flowing nicely, are you able to tell if you expressed your glands and used a magnified mirror. I am asking because I am told one is able to see the oil and I am finding it difficult. So how are you supposed to express them? I am glad you are finding relief.

I've tried looking before and I couldn't see anything! Of course, I wasn't using a magnifying mirror. I haven't tried again since receiving his instructions. He said to take a Q-tip and push it gently under the eyelid margin and (for lower lids) to push gently up. If felt like he was rolling the Q-tip up as he was pushing. He pushed very gently. I was shocked he could actually see the oil. I specifically asked him "so you can see the oil coming out?" and he said, "oh yea, it's flowing nicely." Of course he was looking through his fancy optometry equipment so who knows what kind of magnification he had or if he was using optical filters or something like that. Since he said I didn't have major blockages I wasn't going to get in the habit of futzing around with my glands! But I can certainly give it a try and let you know if I can see anything. I guess my glands would be a good "positive control" since I know they are still working. Give me a day or two and I will get back to you.

[willwork4tears]

Normal glands - can't see a thing.

SAAG - YEAH!!!! I'm so happy things starting flowing again. I was thinking about cautery the other day and wondering if I should consider it. Reading your post made me much more optimistic that this would be a viable option for me as well.

Chemia - Ok...so I told my husband I needed to find a magnifying mirror because I was "on a mission for a DEZ person" and he started singing the Mission Impossible theme song - too funny!

So I took a Q-tip and rolled it up against my lower eye lid margin and pushed like crazy. I can't see a thing. Part of the problem is I don't have a good magnifying mirror. The other problem is when I push on my eyelid, it pushes against my eyeball and this distorted my vision. Then I can't really tell what's going on. But my conclusion, thus far, is that I can't see a thing. I didn't seen anything coming out. I didn't see any oil "beading" up on the lid margin. The only thing I saw was wetness from my eyes watering from being jabbed with a Q-tip about 20 times!

Maybe the reason we can't see anything is because our secretions are normal. If our secretions are thin and clear they are probably difficult to see. I imagine if I had toothpaste-like discolored stuff coming out I would be able to see it! My doctor said my glands work pretty well and I trust his judgment. In this case, I would assume your doctor got it right and give yourself a break from the worrying for a while.

[Lucy]

You folks who are a bit scared of cauterization--I don't think you should be since you're already suffering from dry eye. I've been cauterized, plugged, quadraplugged and scarred shut.

The numbing drops used to hurt me so bad later that I began telling my eye doc to do whatever it was he was going to do--without the numbing drops. However little the cauterization hurt for that moment, or other things he did, was nothing like the numbing drops would burn my eyes for 48 hours or more.

Cauterizatiion is not to be afraid of. If this is what you and your doc have decided is best for you. It is not something to be entered thinking it can be undone. Lucy

[Guest]

Another update...

My eyes are still gloriously wet compared to pre-cautery.

The foreign body sensation I had where my puncta were cauterized is completely gone now.

Strangely, even though my eyes are very wet, the inside corners of my eyes are prone to bouts of itching still... but this is not a huge concern to me, since by blinking lots, I can rewet the area and alleviate the itching.

I still blink at least once per second to keep my eyes comfortable.

I had a great day today: worked a 5 hour shift in a slow store (easy on the eyes!), used the comp for 1.5 hours, and watched a movie - all this with no goggles, no need for drops, and eyes that felt 90% normal. Even under florescent lights at work, my eyes were only a little bit pink.. so not too bad at all!

[willwork4tears]

oooh... I'm so jealous. I had to go back to the eye dr today b/c my collagen plug that was supposed to dissolve in 2-3 months fell out in a week! He had only plugged the left lower punctum. I chose to do this so I could directly compare it to the unplugged right eye. I'm a scientist, so I needed a negative control, right? Well it totally worked. I could tell immediately that my left eye felt better than the right eye. The stinging/burning/menthol sensation had decreased by 80-90% and the gritty sensation had decreased by 50-75%. Then the damn thing fell out! Grrrrr...

So I got replugged today and now that I know the plug actually helped, he plugged the right eye, too. I asked him if they popped out again if he would consider cautery on me and he said "absolutely." Woohoo! So next time these babies fall out I'm scheduling cautery.