Eyelid swelling, rosacea; would removing plugs help?

[y-gwair]

Have been doing some reading on here about rosacea, and the consensus seems to be that having punctal plugs with untreated rosacea isn't a great idea. I've had discomfort and some swelling in the lids for some years, but it has been much worse since I had the plugs inserted. The swelling is mostly limited to the inner portions of the eyelid, seems to have some association with papilliary conjunctivitis, blocked glands and enlarged (inflamed?) veins on underside of the lid.



I am wondering if I should ask to have the plugs removed; although they have had a positive effect on the tear film/corneal surface I've barely had an hour's comfort since they went in. I don't actually have a diagnosis for rosacea/MGD, so haven't had any specific treatment for it.

I did have a similar flare 5 years ago, which subsided of its own accord after about 5 months (probably had a slightly more tears back then). I read that some ophthalmologists don't believe in treating ocular rosacea, as flares can be self-limiting within the same time-frame as it takes oral antibiotics to work. This was my experience last time this happened, it was triggered by extreme stress, and eventually improved a lot of its own accord, but that was without the complicating factor of plugs perpetuating an inflammatory vicious circle, which steroids haven't helped to break.

I'm sure stress is still a factor now, lack of sleep from lid pain and inability to follow virtually all normal activities are taking a terrible toll psychologically. The last few days I've woken up feeling dazed and barely able to move, I suspect this is a sign of quite serious depression setting in.

[Margaret]

My eyes look similar, just not quite as swollen on the inside. I would remove the plugs immediately. I have a feeling if I could treat my lids then my eyes wouldn't be so dry, probably not the other way around. We have the exact same problem, I am sure. I don't know if it's a combination of ocular rosacea and bletharitis, but the end result is eye lid pain and MGD. My doc just put me on a round of 200 mg doxy for two weeks and then down to 100 mg a day for the rest of the month. I never had these problems before Lasik. I sometimes think my eye surface is actually improving and my lids are actually worsening. It's aggravating. I am very scared that the Doxy won't work. After that, what treatment is there? I'm afraid nothing. My doc wants me to do hot compresses too. I understand his theory - get the oils loosened up and flowing again, but the heat really does a number on my eyes the next day, so I'm sure it increases inflammation. I would also suggest going on Rosacea Community Support forum there. It also has a group like this but with ocular rosacea. Maybe they have tips? Hang in there. It's hard for me to say it, because I'm not doing so well hanging in there myself. What if relief is on it's way and we just don't know it today? Maybe it will come tomorrow, or maybe it will take months, but what if it comes? I want to be ready when it does

Margaret

[y-gwair]

My husband thinks I should just give it a chance to go away of its own accord, without further messing around as when it went through an acute phase like this before and gradually got better after about 5 or 6 months without any treatment (but not to the extent that I could ever wear even hypo-allergenic make up on my face or around the eyes again).

I worry that having the problem acutely for so long will cause ongoing damage, and permanent scar tissue to build up, so I'd rather treat it more aggressively. The papilliary conjunctivitis seems to be in the area where the lid has become thickened, possibly due to tightness/friction on that portion of the lid and eye surface when it swells up at night. Difficult as ophthalmologist initially said she didn't think I had a blepharitis/MGD problem; maybe it has just got substantially worse since trying plugs, drops, and steroids?

[drrd2005]

actually i feel this requires constant evauation by an ophthalmologiist.all cases are different .I had a friend who had some eye complaints.he even asked online ophthalmologists on just answer and proctoraid.com sites .the later is very cheapjust adollar .maybe you should try that or homeopathy.

[y-gwair]

actually i feel this requires constant evauation by an ophthalmologiist.all cases are different .I had a friend who had some eye complaints.he even asked online ophthalmologists on just answer and proctoraid.com sites .the later is very cheapjust adollar .maybe you should try that or homeopathy.

Equally, perhaps you should try not to spam support groups?

[drrd2005]

Equally, perhaps you should try not to spam support groups?

I dont get a dime if you visit justanswer website .Its a million dollar website and they dont require spam ......its like me suggesting youtube videos.
homeopathy and proctoraid.com i suggested as one is an alternative and the other is cheap.

This is support ....

[Rebecca Petris]

I dont get a dime if you visit justanswer website .Its a million dollar website and they dont require spam ......its like me suggesting youtube videos.
homeopathy and proctoraid.com i suggested as one is an alternative and the other is cheap.

This is support ....]

Sorry but I do not believe that any general ask-a-doctor website, no matter how good, is going to solve problems for people in this group. Our needs are highly specialized and most people who come here have already searched a lot of sites. In this area of eyecare we have enough difficulty getting helpful answers from the best fellowship trained corneal specialists in the country - when we're sitting right there in their office.... let alone over the internet. When people ask specific questions here they expect feedback that is relevant to the specific question and if they get referred to a nonspecialist website they're going to be suspicious of why it was posted.

I am wondering if I should ask to have the plugs removed; although they have had a positive effect on the tear film/corneal surface I've barely had an hour's comfort since they went in. I don't actually have a diagnosis for rosacea/MGD, so haven't had any specific treatment for it.

How long have you had them? What kind are they? Any possibility they could be replaced with something more comfortable, or made of something different?

[Rebecca Petris]

drrd2005

I have sent you a private message. Please check it and reply. Thank you.

[y-gwair]

How long have you had them? What kind are they? Any possibility they could be replaced with something more comfortable, or made of something different?

Had them 3 months, just lowers, not sure which sort, fitted at UK's leading eye hospital. The plugs/puncta themselves are fine, wouldn't know they are there but have increased overall sensation of burning within eye, swelling of upper lids, also right sinus has been runny/blocked since they were fitted. Have tried lid scrubbing, compresses, flushing with celluvisc; steroid drops seem to make problems worse. Seeing ophthalmologist again tomorrow to discuss, clearly rather more going on than we initially thought.