Need Advice for MGD and ATD

[hosanna13]

So I'm 9 months post-LASIK and have both my lowers plugged. For a month after getting them plugged, I was almost asymptomatic. The pain was reduced significantly. Now, my the pain in my right eye has come back, although not as severe as pre-plugs. My theory is that my tear production decreased after plugs in a negative feedback loop.

I'm wondering if I should get my right upper cauterized. Will this only help temporarily? Will my tear production decrease again with both puncta blocked? Please let me know if you've had similar experiences. I've also heard that having both puncta plugged will increase inflammation of the eyeball.

Thanks.

[NotADryEye]

I'm not post-LASIK, but IMO, it's best to have Schirmer's tests performed specifically to determine which ducts and how much to cauterize. Some ophthalmologists know how to do this, others don't.

Having both puncta plugged can cause inflammation. But that depends on your level of sensitivity plus the quality of your tears, meibum, etc. Mine are partially closed for aqueous deficiency and I do have inflammation due to a host of factors e.g. I am highly sensitive, demodex mites, poor quality meibum, etc.

If you are thinking about having the uppers cauterized, there is a technique which is reversible in the office that some doctors do. Others do something more permanent. You might opt for the temporary version.