discomfort after cautery?

[karensumner]

last time i had cautery my eye was more dry for months after.. the other eye i had cautery on months before did great.
now i lost my lower 2 plugs and they have scarred over-if they reopen later the doc is talking about cautery-the only thing I worry about is my eyes flaring up really bad after. i think it is because i have Sjogren's syndrome..

any thoughts or advice?
thank you very much
K.

[lulu]

Hi
The first time on here for nearly a year. Saw your post and it seems your problems are pretty identical to mine. I got my Right eye double plugged last December and it settled a bit. I have Sjogrens too. I moved away from all eye subjects to concentrate on caring for my dying Mother in Law with my husband. My plugs stayed put until June when the upper came out. I knew it had happened as it did feel a little drier but we think it was partially blocked as when the surgeon probed it under aneasthetic he could not get the plug back in. I noticed it was very bad after the injection and all the chemicals they used but stupidly agreed to have it cauterised 4 weeks ago. Big mistake as I have now gone very very dry and pretty much permanent I guess. I pray in a way that it will open as I am now thinking it might be better for some drainage of the now very inflamed surface. So, like you I suspect that Cautery is instrumental in causing extreme flare that lasts a long long time. It had never settled from the op in June so I should never have gone near it. Such a difference to the relief I gained from double plugging.
I dont know if you can tolerate steroid drops, if they might help you get the inflamation under control but they do not help me, in fact I have now become pretty intolerant of everything artificial. I hope that you find something that helps and when I see my optho in December who may be able to offer something (I doubt that somehow) I will let you know.
Regards
Lulu

[karensumner]

You won't be dry forever from the cautery--mine did settle down but my doctor(s) say that it was a sjogren's flare (they suspect) as that eye kept getting drier and drier even before cautery. It was my right eye-i am glad i did it because the plugs wouldnt stay in. the left eye however was cauterized a 3 different times (2 dif docs) and i never flared up from that and the left eye was always my worst/driest eye. odd to me

my lower puncta have scarred shut *if they reopen i am going to discuss wtih my doc ( when i go in dec) what to do. because my right lower puncta was really big as it has scarred shut 2 x and the first time reopened after a year! weird.

thank you for replying Lulu! I wish you the best and will pray your eye feels better asap. and it will because mine did after several months-it just stinks having to go through that time .. but eventually my eyes got to wear they overtear a lot so i think the same will happen for you.

[karensumner]

Hey-i reread your post.. I was curious as you say that you say your eye got bad after the injection and the chemicals used when they probed it? and that was in June? and just 4 weeks ago you had cautery?? so are you saying it has been super dry since you had it probed? if so i would think the plug popping out could be part of a flare maybe -i don't think the probing caused the probe. i don't know-i had my puncta probed too when it had grown shut and then partially opened-the doc probed to get a plug in and i didnt flare up from that or the aesthetic..

I hope to hear from you cause we have/had gone through similar situations!!! it would be nice if we could figure this out.. i know i have had 6 months or more with one eye unbearably dry and nothing to do with plugs/cautery-just sjogrens! ughh..

My plugs stayed put until June when the upper came out. I knew it had happened as it did feel a little drier but we think it was partially blocked as when the surgeon probed it under aneasthetic he could not get the plug back in. I noticed it was very bad after the injection and all the chemicals they used but stupidly agreed to have it cauterised 4 weeks ago. Big mistake as I have now gone very very dry and pretty much permanent I guess. I pray in a way that it will open as I am now thinking it might be better for some drainage of the now very inflamed surface. So, like you I suspect that Cautery is instrumental in causing extreme flare that lasts a long long time. It had never settled from the op in June so I should never have gone near it. Such a difference to the relief I gained from double plugging.

[lulu]

Hey-i reread your post.. I was curious as you say that you say your eye got bad after the injection and the chemicals used when they probed it? and that was in June? and just 4 weeks ago you had cautery?? so are you saying it has been super dry since you had it probed? if so i would think the plug popping out could be part of a flare maybe -i don't think the probing caused the probe. i don't know-i had my puncta probed too when it had grown shut and then partially opened-the doc probed to get a plug in and i didnt flare up from that or the aesthetic..

I hope to hear from you cause we have/had gone through similar situations!!! it would be nice if we could figure this out.. i know i have had 6 months or more with one eye unbearably dry and nothing to do with plugs/cautery-just sjogrens! ughh..

My plugs stayed put until June when the upper came out. I knew it had happened as it did feel a little drier but we think it was partially blocked as when the surgeon probed it under aneasthetic he could not get the plug back in. I noticed it was very bad after the injection and all the chemicals they used but stupidly agreed to have it cauterised 4 weeks ago. Big mistake as I have now gone very very dry and pretty much permanent I guess. I pray in a way that it will open as I am now thinking it might be better for some drainage of the now very inflamed surface. So, like you I suspect that Cautery is instrumental in causing extreme flare that lasts a long long time. It had never settled from the op in June so I should never have gone near it. Such a difference to the relief I gained from double plugging.

Hiya
Thanks for looking at my post.
I am now intrigued that you say a flare could cause the plug to fall out? I have had the plugs come out without my eyes too bad but I am open minded to what you have suggested.
My eyes actually teared for a few days after the cuatery middle of October and then just have dried completely. Have checked to see whether it is open and it is not, looked under magnification, looks very different to last cautery on lower duct which opened within three months it turmed out. I really want them to start tearing, last December they teared for a few months and it was Heaven!! Am concerned as the Brain does have a tendency to self regulate the tear production and perhaps that it is what it has done over the last year?
Thanks for your encouraging words however. Are you on anything for your Sjogrens? My Rhematologist wants me to start Aziathioprine but waiting until Jan after I have finished my counselling studies as do not wish to have side effects when written work to be handed in.
Lets keep in touch.
Lulu

[DCRdryeye]

I'm having partial cautery on both punctums of my Left eye next month. It will involve some light sedation since the opththalmologist is attempting to close them, but not completely so it takes longer. The plan is then to insert plugs, however I was advised it will take three months to heal before he will put plugs in. So it definitely is a procedure that causes a wound and the body reacts (the immune system) to heal it. Perhaps it invites white blood cells to the area (dry eye patients already have increased T cells on their ocular surface) and makes the problem worse...temporarily until the cautery wound is healed. Just a theory

[lulu]

I'm having partial cautery on both punctums of my Left eye next month. It will involve some light sedation since the opththalmologist is attempting to close them, but not completely so it takes longer. The plan is then to insert plugs, however I was advised it will take three months to heal before he will put plugs in. So it definitely is a procedure that causes a wound and the body reacts (the immune system) to heal it. Perhaps it invites white blood cells to the area (dry eye patients already have increased T cells on their ocular surface) and makes the problem worse...temporarily until the cautery wound is healed. Just a theory

Hi
Yes that is a good point and has they were already irritated after the a few months of dryness it could be contributing. I think that some of the chemicals they instill like the iodine and the numbing drops just tip the goblet cells on the eyes over the edge if they are inflamed anyway. Its a bugger I cant tolerate steroid drops.
My sincere good wishes for some luck for you, reading your story a few years ago, you certainly deserve it.
Lulu

[DCRdryeye]

Thanks lulu...much appreciated

[karensumner]

Lulu i was curious if you are feeling better after cautery??? I hope!!